Aim To analyze the effect of early and large administration of atorvastatin on coronary microcirculatory disturbance and ventricular remodeling in patients with acute myocardial infarction （AMI）. Methods The 164 patients with AMI were chosen and divided into two groups, research group （pre-PCI administered atorvastatin 40 mg at draught and post-PCI oral intake of atorvastatin 20 mg, bid） and control group （post-PCI oral intake of atorvastatin 20 mg, qn）, according to dosage regimen of atorvastatin. Each group had 82 cases. After one year follow-up, the levels of serum nitric oxide （NO）, vascular endothelial growth factor （VEGF） and thromboxane β2 （TXβ2） were detected and compared between two groups. And the levels of left ventricular ejection fraction （LVEF）, left ventricular end-systolic volume （LVESV）, left ventricular end-diastolic volume （LVEDV） and wall motion score index （WMSI） were also detected and compared between two groups. The classes of thrombolysis in myocardial infarction （TIMI） and myocardial blush grade （MBG） of patients which received coronary angiography were compared between two groups. Results Compared to control group, the levels of serum NO and VEGF in research group were higher, but serum TXβ2 were lower （P<0.05）. And the levels of LVESV, LVEDV and WMSI in research group were lower than in control group, but the level of LVEF was higher than in control group （P<0.05）. The classes of TIMI and TMPG in research group were better than in control group （P<0.05）. Conclusion The early administration of atorvastatin can obviously improve the coronary microcirculatory disturbance and ventricular remodeling in patients with AMI.