Objective To explore the potential relationship of EL-384 A/C gene polymorphism with acute coronary syndrome(ACS) and blood lipids in the eldelry. Methods The EL gene promoter-384A/C genotype in 241 aged ACS patients and 181 controls was detected by polymerase chain reaction-restriction fragment length polymorphism analysis. Results There was EL gene-384A/C polymorphism in elderly Chinese Han population in Changzhou region. The C allele frequency was 13.74%. There was no significant difference in the genotypes and allele frequencies of EL-384A/C between the controls and elderly ACS patients. After adjusting for the risk factors of coronary heart disease, including gender, age, diabetes mellitus, hypertension, smoking and hyperlipidemia, no association between EL-384 A/C gene polymorphism and ACS was observed in the elderly. Additionally, the levels of blood lipids were not significantly different between AA genotype and AC+CC genotype. Conclusion There is no significant association between EL gene-384A/C polymorphism and ACS and blood lipids in the elderly. This EL gene-384A/C polymorphism might not be involved in the pathogenesis of ACS in elderly Chinese Han population in Changzhou region.