Aim To explore the relationship between serum monocyte chemoattractant protein-1 (MCP-1) level and MCP-1 2518G/A polymorphism in patients with acute myocardial infarction (AMI) in Chinese Han population in Lianshui County of Northern Jiangsu. Methods Serum MCP-1 level was measured by ELISA, and the MCP-1 2518 G/A polymorphism was genotyped by PCR-RFLP in 94 patients with AMI and 73 control subjects. Results Serum MCP-1 level(expressed in M/IQR) was significantly higher in AMI group (186.24/285.15 ng/L) than that in control group (100.71/134.02 ng/L, P＝0.001). Multiple linear regression analysis revealed that the serum MCP-1 level was negatively correlated with male, positively correlated with smoking, history of diabetes mellitus and hypertension, but unrelated with old age and dislipidemia in AMI group. After adjustment for hypertension, diabetes mellitus, age, gender, dislipidemia,and smoking, serum MCP-1 level of higher than 75% quantile was positively correlated with the risk of AMI (OR=2.4,5%CI was 1.061～7.204, P=0.037). There was no significant difference in genotype distribution and allele frequency of MCP-1 2518G/A between AMI group and control group (P＞0.05). There was no significant difference in serum MCP-1 level among the genotypes of the control group and the AMI group (P＞0.05). Conclusion Serum MCP-1 level was significantly higher in AMI group than that in control group in Chinese Han population in Lianshui County of Northern Jiangsu. Serum MCP-1 level was affected by sex, hypertension, diabetes, and smoking, but serum MCP-1level of higher than 75% quantile was an independent predictor of AMI. MCP-1 2518G/A polymorphism did not increase the susceptibility of AMI, nor affect the serum level of MCP-1.