Aim To evaluate the myocardial reperfusion of patients with acute myocardial infarction under treatment of fasudil by myocardial blush grades （MBG） after coronary stent implantation. Methods Ninty-two patients with acute myocardial infarction were randomly divided into treatment group and control group. Patients in the treatment group were given fasudil intra-vena twice a day for 7～10 days besides the ordinary treatment while the ones in the control group were only given ordinary treatment. Coronary artery angiography and coronary stent implantation were taken after treatment and myocardial reperfusion was identified by MBG. Results The MBG of treatment group improved significantly （P<0.05） compared with control group. Conclusions The routine treatment plus fasudil hydrochloride therapy can improve myocardial reperfusion in patients with acute myocardial infarction after coronary stent implantation.