Abstract: Objective Acute coronary syndrome belong to clinical common acute cardiovascular disease that is leading causes of deaths. In order to provide a basis for clinical treatment, we investigate the relationship between UA and Hcy, T cell subset and blood lipid in patients with acute coronary syndrome. Methods A total of 84 patients with acute coronary syndrome were divided into UAP group (40 cases) and AMI group (44 cases) from April, 2015 to October, 2016, and 40 healthy subjects were selected as control group. UA, Hcy, T cell subset and blood lipid were determined and compared in3 groups, and to investigate the relationship between UA and Hcy, T cell subset and blood lipid in patients with acute coronary syndrome. Results UA and Hcy of UAP and AMI group were significantly higher than those in control group (P <0. 05), and UA and Hcy of AMI group increased more significantly (P < 0. 05); CD4⁺CD25⁺ Treg and CD4⁺CD25^high Treg of UAP and AMI group were significantly lower than those in control group (P < 0. 05), and CD4⁺CD25⁺ Treg and CD4⁺CD25 ^highTreg of AMI group decreased more significantly (P < 0. 05); TC、TG、LDL of UAP and AMI group were significantly higher than those in control group (P < 0. 05), HDL of UAP and AMI group were significantly lower than those in control group (P < 0. 05), and there was no significant difference between UAP and AMI group (P > 0. 05); Correlation analysis showed that UA positively correlated with Hcy, TC, TG and LDL in patients with acute coronary syndrome (P <0. 05), UA negatively correlated with HDL in patients with acute coronary syndrome (P < 0. 05). Conclusion Acute coronary syndrome patients with UA, unusually high Hcy levels, immune function decline, lipid metabolic disorder, and the UA levels associated with Hcy and lipid levels.