Aim To investigate the effect of improved door-to-balloon (D2B) time on outcomes in patients diagnosed with ST-segment elevation myocardial infarction (STEMI) in non percutaneous coronary intervention (PCI) centers. Methods A total of 200 STEMI patients within 12 h presenting were enrolled. D2B time, first medical contact-to-balloon (FMC2B) time and symptom-to-balloon (S2B) time were recorded. According to D2B time, all patients were divided into D2B<60 group (n=148) and D2B≥60 group (n=52). FMC2B time and S2B time were compared between the two groups. Major adverse cardiac and cerebral events (MACCE, including cardiogenic death, non-fatal myocardial infarction, non-fatal stroke, re-admission of unstable angina or heart failure) and all-cause mortality during follow-up of two groups were observed. Cox regression analysis was used to explore the association of D2B time and MACCE. Results D2B<60 group had shorter FMC2B time and S2B time than D2B≥60 group (P=0.013; P=0.027). Compared to D2B≥60 group, D2B<60 group had lower MACCE and all-cause mortality (P=0.008; P=0.047). Cox regression analysis showed that a D2B time less than 60min was an independent factor associated of MACCE (HR 0.0,5%CI 0.224~0.862, P=0.017). Conclusion A D2B time less than 60min can shorten symptom-to-balloon time and improve MACCE and all-cause mortality in STEMI patients not presenting in PCI center.