Objective To explore the clinical efficacy of alirocumab combined with ybutimibe in acute ST segment elevation myocardial infarction （STEMI）. Methods A total of 112 cases of STEMI patients were randomly divided into control group and study group， with 56 cases in each. All patients underwent PCI treatment after admission. The control group received oral administration of atorvastatin after the surgery， while the study group received combined treatment of atorvastatin with alirocumab. After 6 months of maintenance treatment， the low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， triglycerides， total cholesterol， left ventricular ejection fraction （LVEF）， early and late diastolic peak flow velocity ratio （E/A） of the mitral valve orifice， left ventricular end-systolic diameter （LVESD）， N-terminal pro-brain natriuretic peptide （NT-proBNP）， cardiac troponin I （cTnI）， lipoprotein-associated phospholipase A2 （Lp-PLA2）， matrix metalloproteinase-9 （MMP-9）， interleukin-6 （IL-6）， thrombolysis in myocardial infarction （TIMI） flow grade， drug toxicity， and postoperative cardiovascular adverse events were compared between the two groups. Results After treatment， the level of LDL-C， triglycerides， and total cholesterol in both groups decreased， and more significant results were found inthe study group （P < 0.05）. There was no significant difference in HDL-C between the two groups before and after treatment （P > 0.05）. After treatment， LVEF and E/A in both groups increased， with more significantresults in the study group （P < 0.05）. LVESD， NT-proBNP， cTnI， Lp-PLA2， MMP-9， and IL-6 in both groups decreased after treatment， with more significant resultsin the study group （P < 0.05）. The proportion of TIMI III grade in the study group was higher than that in the control group （P < 0.05）， and there was no significant difference in the incidence of drug adverse reactions and postoperative cardiovascular adverse events between the two groups6 months after surgery（P > 0.05）. Conclusion The combination of alirocumab and ybutimibe in the treatment of STEMI PCI patients is more helpful in reducing blood lipid levels， promoting blood flow perfusion and improving myocardial function， and has good safety.