Aim To discuss the influence of reteplase thrombolytic therapy and emergency PCI treatment on ventricular remodeling and left ventricular function after acute myocardial infarction within 3 hours. Methods 98 patients were randomly divided into reteplase thrombolytic therapy group and emergency PCI treatment group. Compare cardiac function indexes of the two groups, such as NT-ProBNP, ejection fraction, end systolic volume index, end diastolic volume index, ventricular wall motion score index. Results There were no significant differences between the two groups in NT-ProBNP, ejection fraction, end systolic volume index, end diastolic volume index and ventricular wall motion score index (P＞0.05). Conclusion These two treatments have the same effect on the left ventricular function in acute myocardial infarction within 3 hours. Both of them are effective reperfusion therapies. They can reduce and delay ventricular remodeling, and reduce the incidence of heart failure.