【Abstract】 Objective To analyze the effect of different operative approaches on the curative effect in patients with ST segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) and the stay time in coronary care unit (CCU). Methods〓110 patients with STEMI treated by emergency PCI in the hospital from January 2015 to May 2016 were enrolled in the study, including 60 patients treated with transradial interventional puncture (TRI group) and 50 patients treated with ransfemoral interventional puncture (TFI group). The clinical data of two groups were collected, and the curative effect was compared. The success rate of puncture, the success rate of PCI, puncture time, Xray exposure time, balloon dilatation time, the number of angiographic catheters, the dosage of contrast agents, operation time, puncture point compression time, stay time in CCU and total hospitalization time were statistically analyzed. The incidence of complications and adverse events during followup were recorded. Results〓There was no significant difference between the two groups in the success rate of puncture and the success rate of PCI (P＞005). The number of angiographic catheters in TRI group was smaller than that in TFI group, the puncture point compression time, postoperative time in bed, stay time in CCU and total hospitalization time were shorter than those of TFI group (P＜005). The incidence of vagus reflex and urinary retention in TRI group was lower than that in TFI group (P＜005), but there was no significant difference in the incidence of adverse events and recurrence rate during followup (P＞005). Conclusion〓The curative effect of emergency PCI on STEMI under TRI and TFI is definite, but TRI can shorten the time in bed, the stay time in CCU and the hospitalization time, and reduce the complications of operation.