To investigate the effect of tirofiban combined with dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI) undergoing elective PCI. Methods A total of 72 AMI patients with elective PCI admitted to The First Affiliated Hospital of USTC from June 2018 to May 2020 were randomly divided into study group with tirofiban combined with DAPT and control group with ordinary DAPT. The differences in chest pain symptoms, perioperative bleeding rate, cardiac adverse events, coronary TIMI blood flow grade and LVEF between the two groups were analyzed. Results The ratio of patients without chest pain was 94.6% in the study group higher than that in the control group (77.1%) (P＜0.05). There was no significant difference in perioperative bleeding rate between the study group and the control group (P＞0.05). The rate of adverse cardiac events was significantly lower in the study group (10.8%) than in the control group (31.4%)(P＜0.05). There was no significant difference between the study group and the control group in the number of people who obtained TIMI3 level of blood flow before stent being released (P＞0.05). However, the number of patients in the study group (97.3%) with blood flow TIMI3 after stent being released was higher than that in the control group (77.1%)(P＜0.05). Before being acquired PCI treatment, there was no significant difference in LVEF between the study group and the control group in each criminal vessel group (P＞0.05). After being acquired PCI treatment, the LVEF of patients with LAD and LCX lesions in the study group were higher than that of the control group(P＜0.05), but there was no difference in LVEF of patients with RCA lesions between the study group and the control group (P＞0.05). Conclusion Tirofiban does not increase the risk of bleeding. It combined with DAPT can restore coronary blood flow, reduce the incidence of cardiac events and improve cardiac function in AMI patients. Therefore, it has potential benefits for AMI patients undergoing elective PCI.