Aim To study the effect of remote ischemic postconditioning (RIPostC) on the clinical prognosis of patients with ST-segment elevation myocardial infarction (STEMI) who received direct percutaneous coronary intervention (PCI) and to evaluate the health economics. Methods A total of 309 patients with STEMI diagnosed in the First Affiliated Hospital of Xinjiang Medical University from February 2016 to October 2018 were enrolled in this prospective study.According to the random number table, the patients were divided into two groups:the RIPostC group (n＝155) and the control group (n＝154). Patients in RIPostC group completed three rounds of ischemic postconditioning of lower extremities before direct PCI. The area under creatine kinase isoenzyme (CK-MB), major adverse cardiac events (MACE) and direct medical expenses were compared between the two groups. The average out-of-hospital follow-up was 1.5 years. The incidence of out-of-hospital MACE and the direct medical expenses of re-admission were compared between the two groups. Results The cumulative release of CK-MB within 48 hours after admission in the RIPostC group was lower than that in the control group (P＜0.05). The incidence of total MACE in the RIPostC group was lower than that in the control group (P＜0.05). The incidence of out-of-hospital total MACE in the RIPostC group was lower than that in the control group (P＜0.05), and the out-of-hospital mortality rate was lower than that in the control group (P＜0.05). The cumulative incidence of MACE events in the two groups was compared by Kaplan-Meier curve. The results showed that the Kaplan-Meier curve was significantly separated 50 days after PCI, and the cumulative incidence of out-of-hospital total MACE in the RIPostC group was lower than that in the control group (P＜0.05). The direct medical expenses during hospitalization and re-admission in the RIPostC group were lower than those in the control group (P＜0.05), respectively. Conclusion As an adjuvant therapy in the treatment of PCI, RIPostC can not only improve the clinical prognosis of patients with STEMI, but also reduce the economic burden of patients.