Abstract: Objective To investigate the relationship between patients with acute myocardial infarction (AMI) underwent intravenous thrombolytic therapy and red cell distribution width (RDW). Methods Clinical data about 268 patients with AMI receiving thrombolytic therapy in the First Affiliate Hospital of the Third Military Medical University from August 2003 to August 2013, including related medical history, experimental results and thrombolysis in myocardial infarction (TIMI) level, were retrospectively analyzed. According to TIMI level, all patients were classified into TIMI 0-1 group and TIMI 2-3 group, and the RDW> 14.8% was identified as high RDW. Odds ratio (OR) of incident complication was calculated using logistic regression. Result TIMI 0-1 group and TIMI 2-3 group had significant difference in gender, triglyceride (TG), high-sensitive C-reactive protein (hs-CRP), cardiac troponin I (c-TnI), and RDW (P< 0.05). Meanwhile, logistic regression analysis showed that high RDW (> 14.8%) was positively correlated with TIMI flow 0-1 as independent predictors (odds ratio:1.239, 95% confidence interval 1.130- 1.358; P< 0.05). Conclusion High RDW level is positively correlated with the worse reperfusion in AMI treated with intravenous thrombolysis.