Abstract: Objective To analyze the risk factors of gastrointestinal bleeding after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in elderly patients, and to provide a reference for the clinical treatment of AMI patients. Methods Ninety elderly patients with AMI were diagnosed in our hospital were selected from January, 2016 to March, 2017. The patients with gastrointestinal hemorrhage after PCI were included in the observation group (n=47), and the normal gastrointestinal patients were included in the control group (n=43). The general data (gender, age, the time of diagnosis and therapy, Killip rating of myocardial infarction, blood vessel length, hypertension, peptic ulcer and renal function), clinical index (triglycerides, plasma cholesterol, albumin, c-reactive protein, activated partial thromboplastin time, prothrombin time and left ventricular ejection fraction) and surgical data (surgical time, the number of scaffolds, the use of tirofiban, thrombus aspiration and the level of preoperative and postoperative TIMI blood) were compared between the two groups, and analyze the risk factors of gastrointestinal bleeding after PCI in elderly patients with AMI by binary logistic. Results The length of blood vessel, peptic ulcer, the function of renal, the level of albumin and c-reactive protein, the number scaffolds and the use of tirofiban in observation group were significantly differences with control group (P<0.05). The binary logistic showed that the main risk factors of gastrointestinal bleeding are the renal function, c-reactive protein level and the use of tirofiban. Conclusion The renal function, c-reactive protein level and the use of tirofiban are the risk factors of gastrointestinal bleeding after PCI in AMI elderly patients.