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Objective: To explore the risk factors of malignant ventricular arrhythmia in patients with acute myocardial infarction (AMI) and analyze the value of QRS-T angle in its diagnosis. Methods: The clinical data of 120 patients with acute myocardial infarction who were admitted to our hospital from August 2015 to August 2019 were analyzed retrospectively, among them, the patients with malignant ventricular arrhythmia served as the study group (n=42), the patients without malignant ventricular arrhythmia served as the control group (n=78), single factor and multiple factor Logistic regression were used to analyze the risk factors of AMI with malignant ventricular arrhythmia, and the diagnostic value of qrs-t angle in AMI with malignant ventricular arrhythmia were analyzed. Results: 42 of 120 patients were complicated with malignant ventricular arrhythmia, the incidence was 35.00%. Logistic regression analysis showed that age≥ 70 years old, hypokalemia, Killip> grade II, troponin I (TnI)≥ 12 ng/mL, left ventricular ejection fraction (LVEF) <50%, inferior posterior wall myocardial infarction, sinus rhythm RR interval standard deviation (SDNN)≥ 90ms, QRS-T angle>90° were risk factors for malignant ventricular arrhythmia in AMI patients (P<0.05). QRS-T angle>90° was the risk factor for malignant ventricular arrhythmia in AMI patients The sensitivity, specificity and accuracy were 83.33% (35/42), 93.59% (73/78) and 90.00% (108/120) respectively. Conclusion: Age≥ 70 years old, hypokalemia, Killip grade>II, TnI≥ 12ng/mL, LVEF<50%, inferior posterior wall myocardial infarction, SDNN≥ 90ms, QRS-T angle >90° are the risk factors of malignant ventricular arrhythmia in AMI patients. QRS-T angle>90° has a good diagnostic value for malignant ventricular arrhythmia in AMI patients. [ABSTRACT FROM AUTHOR]