Aim To evaluate the mid-term prognostic value of serum growth differentiation factor-15(GDF-15) in acute coronary syndrome(ACS). Methods Totally 95 consecutive patients with acute coronary syndrome were included. Their baseline levels of serum growth differentiation factor-15 (GDF-15) were determined using enzyme-linked immunosorbent assay (ELISA). The patients were divided into low concentration group and high concentration group according to median value of GDF-15. The mid-term survival rate and major adverse cardiovascular events (MACE) during the follow-up period were observed using Kaplan-Meier survival analysis method. Receiver operating characteristic (ROC) curve was measured to evaluate the mid-term prognostic value of serum growth differentiation factor-15 in acute coronary syndrome. Results There were 95 cases in the whole study including four deaths. The mean follow-up was 33.76±6.29 months. The serum growth differentiation factor-15 level in acute coronary syndrome patients were 921.56±462.20 ng/L. Survival analysis showed that survival rate in patients with high level of serum GDF-15 was statistically lower than low level of serum group (P=0.039). The area under the ROC curve is 0.853(SE=0.074,P=0.017,95%CI 0.708~0.998)in evaluation of mid-term survival rate and 0.805(SE=0.068,P=0.000,95%CI 0.672~0.938)in predicating MACE. Conclusion GDF-15 level predicted mid-term prognosis in acute coronary syndrome. As a new biochemical marker, GDF-15 is of clinical significance in evaluating risk stratification and mid-term prognosis in acute coronary syndrome.