Abstract: AIM:To assess the safety and the lipid-lowering efficacy of different doses of rosuvastatin in patients with acute myocardial infarction (AMI). METHODS: A total of 232 AMI patients admitted to our hospital from January 2012 to September were divided into intensive treatment group (group A, n=178, rosuvastatin 20 mg/day) and the common dose group (group B, n=54, rosuvastatin 10 mg/day). Patients in group A with increased liver enzyme level (three times higher than normal) at discharge took rosuvastatin 10 mg daily and patients in group B under the same conditions stopped taking rosuvastatin. Lipid profiles, high-sensitivity C-reactive protein, liver and kidney function, and major cardiovascular events were compared at admission, discharge, 1 month and 3 months after discharge. RESULTS: Total cholesterol (TC), LDL-C, apolipoprotein B (apoB) in both groups significantly decreased (P<0.05), and LDL-C level was more significantly decreased 1 month after discharge in group A (P<0.05). Hs-CRP significantly decreased after discharge, with no statistical difference between groups. After discharge, no statistical difference was found in liver and kidney functions between groups. Three-month follow-up showed statistical differences in major cardiovascular events between group A and group B (death, 0 vs. 3, P<0.05). CONCLUSION: Intensive rosuvastatin therapy is safe and more effective for patients with AMI.