Aim To investigate the effect of serum total 25-hydroxyvitamin D on short-term prognosis of acute myocardial infarction. Methods 1324 patients with acute myocardial infarction who underwent emergency percutaneous coronary intervention (PCI) were selected. The clinical data were collected, the total 25-hydroxyvitamin D were tested. Major adverse events were recorded during 1 year follow-up. According to the occurrence of major adverse events, the patients were divided into event group and control group. The clinical characteristics of the two groups were analyzed retrospectively. The patients were divided into three groups according to the serum total 25-hydroxyvitamin D level:vitamin D deficiency, insufficient and normal group. The clinical characteristics and prognosis of the three groups were analyzed. Results There were 217 patients in the adverse event group and 1107 in the control group. The total 25-hydroxyvitamin D level in the event group was lower than that in the control group(P=0.007). The incidence of non-fatal myocardial infarction, unplanned revascularization and the proportion of hypertension and diabetes in vitamin D deficiency group and insufficient group were higher than that in vitamin D normal group. Univariate COX analysis showed that vitamin D deficiency and insufficient were associated with adverse events within 1 year after PCI (vitamin D deficiency OR=2.1,5%CI 1.048-6.553, P=0.039; vitamin D insufficient OR=2.0,5%CI 1.076-7.031, P=0.035). The sensitivity and specificity of ROC curve analysis of 25-hydroxyvitamin D for predicting non-adverse reactions within one year were 56.5% and 59.0% respectively. Conclusion Low level of serum total 25-hydroxyvitamin D was a risk factor for major adverse events after PCI in patients with acute myocardial infarction.