Objective To explore the prognostic value of serum D-dimer(D-D) and fibrinogen(Fib) combined with thromboelastography(TEG) in acute myocardial infarction(AMI). Methods A total of 126 patients with AMI treated by percutaneous coronary intervention(PCI) in the hospital from August 2018 to February 2021 were selected. According to the presence or absence of major adverse cardiovascular events(MACE), the patients were divided into poor prognosis group(with MACE during follow-up, n=41) and good prognosis group(without MACE during follow-up, n=85). The general clinical data, serum D-D, Fib and TEG indicators of the two groups were compared. The correlation of D-D, Fib and TEG indicators was analyzed. The receiver operating characteristic(ROC) curve was used to analyze the prognostic value of D-D, Fib and TEG indicators in patients with AMI. Results The systolic blood pressure(SBP) and diastolic blood pressure(DBP) of the poor prognosis group were significantly lower than those of the good prognosis group, while heart rate(HR) were significantly higher than those of the good prognosis group(P＜0.05). Serum D-D and Fib levels in the poor prognosis group were higher than those in the good prognosis group. The TEG indicators coagulation reaction time(R), coagulation formation rate(Angle angle), maximum amplitude of thrombus(MA) and coagulation index(CI) showed statistically significant differences between the two groups(P＜0.05). Logistic regression analysis showed that serum D-D, FIB, R, angle, Ma and CI were independent risk factors for prognosis(P＜0.05). Correlation analysis results showed that D-D was negatively correlated with R, and was positively correlated with Angle angle, MA value and CI(P＜0.05). Fib was positively correlated with MA value and CI(P＜0.05). ROC curve analysis showed that the AUC values of D-D, Fib, R, Angle angle, MA value and CI for prognosis of patients with AMI were 0.838, 0.824, 0.791, 0.780, 0.808, and 0.677, respectively. The AUC value of combined detection was 0.863(P＜0.05). Conclusion The changes of serum D-D, Fib and TEG indicators are correlated with the occurrence of MACE in patients with AMI after PCI, which suggests that the above indicators all have certain prognostic value in patients with AMI.