Objective: To investigate the predictive value of the ratio of triglyceride to high density lipoprotein cholesterol (TG/HDL-C) on admission to hospital in patients with acute myocardial infarction (AMI) for poor ST segment regression after coronary intervention. Methods: The clinical data of 97 patients with AMI who received interventional therapy in our hospital from January 2023 to December 2024 were retrospectively collected. The patients were divided into poor group (n=27) and complete group (n=70) according to the ST segment regression after surgery. The TG and HDL-C levels were collected and compared between the two groups at admission, and the TG/HDL-C ratio was calculated. Point binomial correlation analysis and ROC curve were used to evaluate its predictive value. Results: The levels of TG and TG/HDL-C in poor ST segment regression group were significantly higher than those in ST segment complete regression group, and the levels of HDL-C were significantly lower than those in ST segment complete regression group (P < 0.05). Point two-column correlation analysis showed that TG and TG/HDL-C levels were positively correlated with poor ST segment regression after AMI intervention (r > 0, P < 0.05). HDL-C was negatively correlated with HDL-C (r < 0, P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of TG, HDL-C and TG/HDL-C in predicting poor ST segment regression after AMI intervention was 0.780, 0.761 and 0.876, respectively, and TG/HDL-C had higher predictive value. Conclusion: TG/HDL-C level at admission of AMI patients has good predictive value for ST segment decline after interventional AMI patients.