ST-segment elevation myocardial infarction (STEMI) is commonly complicated with multivessel coronary artery disease (MVD), and this condition often exerts adverse effects on mortality and prognosis. Compared with single coronary artery disease, MVD is usually associated with poor prognosis. With the development of medical science and update of guidelines, the revascularization strategy for STEMI with MVD has changed dramatically. Emergency percutaneous coronary intervention (PCI) can treat non-infarct-related arteries simultaneously or separately by different stages. However, for those STEMI patients with unstable hemodynamics, complete revascularization increases the risk of complications, deterioration of heart failure and contrast-induced nephropathy. It is reasonable to treat infarct related artery (IRA) only in acute stage. This article reviews the revascularization strategies for STEMI complicated with MVD.