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Objective: To investigate the risk factors of malignant ventricular arrhythmias in elderly patients with ST segment elevation myocardial infarction (STEMI). Methods: 150 elderly patients with acute STEMI were analyzed retrospectively. Based on the presence or absence of malignant ventricular arrhythmia (MVA), the patients were divided into the control group (non-MVA) and observation group (MVA), the clinical data and indicators were compared between two groups. Results: Gender, age, smoking history, history of hypertension, diabetes mellitus, history of angina, blood glucose, glycosylated hemoglobin (HbA1c), serum potassium, creatinine (Cr), BUN, triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), low density lipoprotein (LDL) and lesion type of MVA had no relationship with the occurrence of MVA in elderly patients with STEMI, while Killip classification, Cr, and LDL were correlated with the occurrence of MVA, and Killip class, creatinine levels were independent risk factors for the occurrence of MVA. Conclusions: Killip classification and Cr levels were independent risk factors of the occurrence of MVA in elderly patients with STEMI. [ABSTRACT FROM AUTHOR]