Objective To investigate the effects of indobufen combined with clopidogrel on vascular endo⁃ thelial function，inflammatory factors，and oxidative stress in patients with acute coronary syndrome. Methods This study retrospectively selected 156 patients as the research object who had acute coronary syndrome and underwent PCI in our hospital from June 2020 to March 2022. They were divided into two groups by the number table method， with78 patients in each group. The observation group was treated with indobufen combined with clopidogrel，and the control group was treated with clopidogrel. The efficacy and indicators of patients were compared，and the adverse reactions were recorded. Result The therapeutic effect of the observation group was better than that of the control group（P < 0.05）；After treatment，the endothelial function indicators of both groups of patients were signif⁃ icantly improved compared to before treatment（P < 0.05），and the VEGF level in the observation group was higher than that in the control group（P < 0.05），while ET⁃1 was lower than that in the control group（P < 0.05）；After treatment，the inflammatory factors in patients decreased compared to those after treatment（P < 0.05），and the observation group showed hs CRP and TNF⁃α levels. These levels were significantly lower than those of the control group（P < 0.05）；After treatment，the oxidative stress indicators of patients improved compared to before treat⁃ ment（P < 0.05），and the NO and tNOS indicators in the observation group were significantly higher than those in the control group（P < 0.05），while the malondialdehyde levels were lower than those in the control group（P < 0.05）； The incidence of cardiovascular adverse events and bleeding in the observation group after treatment was lower than that in the control group（P < 0.05）；There was no statistically significant difference in the incidence of adverse reactions between the two groups（P > 0.05）. Conclusion The application of indobufen combined with clopidogrel in the treatment of acute coronary syndrome patients has a definite therapeutic effect that can effectively improve various indicators，reduce the incidence of adverse events，and alleviate inflammation and therefore lead to a low bleeding rate，and good safety，which is worthy of further promotion.