Aim To investigate the predictive value of serum uric acid levels on the short-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods 147 STEMI patients in Cangzhou Central Hospital from January 2018 to May 2021 were selected as the study subjects, all patients underwent PCI treatment. Serum uric acid levels were detected 1 h after PCI, followed up for 30 days, and the prognosis was counted, and patients with different prognosis were compared. According to uric acid levels patients were divided into normal uric acid group and hyperuric acid group. The clinical data and the incidence of major adverse cardiovascular events (MACE) were compared between the two groups, the relationship between serum uric acid and disease indicators and prognosis were analyzed, and its predictive prognostic value was evaluated. Results At 30 days follow-up, the incidence of MACE in 147 patients was 27.21% (40/147). Serum uric acid were higher in patients with MACE than those without MACE (P＜0.05); age, Killip classification, Gensini score, proportion without recurrent flow, preoperative and 1 h postoperative serum uric acid levels were higher in the hyperuric acid group than those in the normal uric acid group (P＜0.05); correlation analysis showed that serum uric acid was positively correlated with Killip classification, Syntax score classification, and the incidence of MACE was higher in the hyperuric acid group than that in the normal uric acid group (48.84% vs. 18.27%, P＜0.05). Logistic multivariate analysis showed a significant correlation between serum uric acid and the occurrence of MACE before and after adjusting for other factors such as age, Killip classification, Gensini score, Syntax score classification, no reflow and preoperative serum uric acid levels (P＜0.05). ROC curve analysis showed that the AUC of serum uric acid for predicting MACE was 0.6,5%CI was 0.731～0.901, best cut-off value was 361.37 μmol/L, sensitivity was 70.00% and specificity was 88.79%. Conclusion The serum uric acid level in STEMI patients after PCI is positively correlated with the occurrence of MACE, which can serve as an important indicator for predicting MACE and providing effective information for clinical practice.