Objective To assess the safety and efficacy of 40mg daily simvastatin for the elderly female patients with acute myocardial infarction(AMI).Methods A total of 221 elderly female patients with AMI admitted to our hospital from Jan 2006 to Dec 2008 were assigned to simvastatin 40mg daily within 24h of hospitalization and continued till 6 months after discharge.Patients with LDL-C<2mmol/L or increased liver enzyme level at discharge received dose of reduced simvastatin,20mg daily.Lipid profiles,high-sensitive C-reactive protein(hs-RP) and liver enzyme level were measured at admission,discharge and 1,3 and 6 months after discharge.Results LDL-C was continuously decreased(mmol/L(3.18±1.02) at admission,(2.19±2.00) at discharge and(1.49±0.79) at 3 months after discharge).HDL-C was decreased from(1.56±0.41)mmol/L to(1.25±0.28)mmol/L at discharge,then increased to(1.75±1.85)mmol/L at 3 months after discharge.Total cholesterol(TC) and triglyceride(TG) were also significantly decreased from admission to discharge.hs-CRP level significantly decreased from admission to discharge and at 3 months after discharge(mg/L(48.92±46.39) vs(9.70±18.25) vs(2.63±2.18)).Increased ALT>120 U/L were found in 24(10.9%),AST>120 U/L were found in 3(1.4%) patients at discharge.There was still a patient with increased ALT>120 U/L at 1 month after discharge and returned to normal at 3 months after discharge.Conclusion Intensive simvastatin therapy with a dose of 40mg daily is safe and effective for the elderly female patients with AMI.