Objective To assess the psychological and clinical effect of transradial artery access for percutaneous coronary intervention(PCI) on elderly patients with acute myocardial infarction(AMI). Methods One hundred and seventy-two patients(>65years) with acute ST segment elevated myocardial infarction were enrolled from Jan,2005 to Jan, 2007.All the patients who underwent PCI were randomly divided into transradial artery group (n=84) and transfemoral artery group (n=88).The psychological changes of the subjects were determined by self-rating anxiety scale(SAS) and self-rating depression scale(SDS).The clinical outcome of the subjects were also observed.Results SAS and SDS indices were decreased significantly in transradial artery group compared to those in transfemoral artery group at 1,6 month after PCI procedure(P<0.05). Statistical analysis demonstrated that different approaches exerted different effects on depression or anxiety of AMI patients.There was no difference in major adverse cardiac events between the two groups. Conclusion Transradial artery access for percutaneous coronary intervention can significantly decrease the incidence of psychological problems in elderly patients with AMI.And also,it is safe and effective.