Aim To investigate the predictive value of miR-150 for major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute ST segment elevation myocardial infarction (STEMI). Methods 130 patients admitted to our hospital from January 2016 to January 2019 who were diagnosed with STEMI and emergency PCI were selected. The patients were divided into MACE group (n＝36) and non-MACE group (n＝94) according to whether MACE occurred within 6 months after PCI. The expression level of miR-150 and general clinical data were compared between two groups. Risk factors of MACE in acute STEMI patients 6 months after PCI were analyzed by Logistic regression. Spearman correlation analysis was used to analyze the correlation between miR-150 and various risk factors. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of miR-150 for MACE within 6 months after PCI in patients with acute STEMI. Results There were no significant difference between the two groups in gender, age, comorbidities (diabetes, hypertension, coronary heart disease, hyperlipidemia), infarction site, postoperative medication, emergency PCI time, high density lipoprotein cholesterol, low density lipoprotein cholesterol, total cholesterol, triglyceride and hemoglobin (P＞0.05). Heart rate (HR), systolic blood pressure, diastolic blood pressure, platelet, C-reactive protein (CRP), creatine kinase-MB (CK-MB), neutrophil lymphocyte ratio (NLR) in MACE group were significantly higher than those in non-MACE group, and left ventricular ejection fraction (LVEF) and miR-150 levels were significantly lower than those in non-MACE group (P＝0.000). Multivariate Logistic regression analysis showed that age, hypertension history, HR, LVEF, CRP, CK-MB, NLR, miR-150 were all independent risk factors for MACE within 6 months after PCI in patients with acute STEMI. The results of correlation analysis showed that miR-150 was negatively correlated with hypertension history, HR, CRP, CK-MB, NLR, and positively correlated with age and LVEF (P＝0.000). ROC curve showed that the cut-off point of MACE diagnosed by miR-150 within 6 months after PCI in acute STEMI patients was 0.23, and the area under curve was 0.905 (95%CI 0.871-0.939). Conclusion Low level of miR-150 is an independent risk factor of MACE within 6 months after PCI in patients with acute STEMI, and the detection of miR-150 level can help to evaluate the prognosis of patients with acute STEMI.