Objective To investigate the risk factors and in-hospital outcomes of recurrent acute myocardial infarction (AMI). Methods A total of 1447 consecutive AMI patients admitted to our hospital from January 2006 to December 2010 were recruited. Their clinical background, angiographic findings, heart function, infarction types, serum indices within 24 h after hospitalization and in-hospital prognosis were retrospectively compared between patients with first AMI (n＝1268) and those with recurrent AMI (n＝179). Logistic regression analysis was used to study the risk factors of recurrent AMI. Results Patients with a recurrent AMI were older and had a higher prevalence of diabetes mellitus (DM) than those with first AMI. In addition, they also had worse heart function at admission and more severe coronary lesions. Logistic regression analysis indicated that the independent risk factors of recurrent AMI included age (OR, 1.03; 95% CI∶1.01–1.04, P＜0.01), DM (OR, 2.10; 95% CI: 1.51–2.91, P＜0.01), smoking (OR, 1.76; 95% CI: 1.20–2.57, P＜0.01), and serum creatinine (OR, 1.003; 95% CI∶1.001–1.004, P＜0.01). Recurrent AMI had an increasing trend in in-hospital all-cause death as well as cardiac-related death compared with a first AMI, though with no significant difference between the 2 groups. Conclusion Age, DM, smoking and serum creatinine are independent risk factors for the recurrence of AMI. Recurrent AMI has no effect on in-hospital death.