Aim To investigate the value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) for evaluating the disease condition and prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods 240 cases of STEMI patients were selected, the average age was 57.28±15.67 years old. Each patient underwent emergency percutaneous coronary intervention. The history of smoking, drinking, hypertension, and diabetes were recorded in each case. Plasma NT-proBNP concentration was measured. Blood biochemical indexes and cardiac troponin I (cTnI), high-sensitivity C-reactive protein (hs-CRP) and blood routine were detected. Color Doppler echocardiography was used to examine the heart. The main adverse cardiovascular events (MACE) occurred within 6 months after discharge were followed up, including cardiac death, nonfatal myocardial infarction, and revascularization of the target vessel blood. Results The plasma NT-proBNP level in patients with STEMI was positively correlated with age and left ventricular end-diastolic diameter (r value was 0.9,0.23, respectively, all P＜0.001), and was negatively correlated with left ventricular ejection fraction (r value was －0.34, P＜0.001). Plasma NT-proBNP concentration increased with the increase of cardiac function Killip grade (P＜0.001), and increased with the increase of Gensini score (P＜0.001). Plasma NT-proBNP concentration was the highest in patients with anterior wall myocardial infarction (P＜0.001). Multiple factor Logistic regression analysis showed that age, Lg[NT-proBNP], cTnI and hs-CRP were all associated with MACE, and Lg[NT-proBNP] was the strongest predictor of MACE (P＜0.001). ROC curve analysis showed that the best cut-off value of NT-proBNP predicting MACE was 4069.5 ng/L. Conclusion The level of plasma NT-proBNP is associated with the severity of the STEMI patient's condition, and NT-proBNP is the strongest predictor of MACE in STEMI patients.