Objective To explore the electrocardiography (ECG) characteristics in Kazak population in Gansu Province, and investigate the related risk factors for abnormal changes of ECG parameters. Methods A total of 846 Kazak people (study group) and 846 Han people (control group) were recruited from the over 40-year-old participants who taking physical examination in Aksai People′s Hospital from January to December 2020. The baseline data and characteristics of ST-segment and T-wave changes in routine 12-lead ECG were analyzed in the two groups. The prevalence of ST-segment shift and prolongation and T-wave changes in the study group was compared in each age group. SPSS statistics 22.0 was used for statistical analysis. Data comparison between two groups was performed using student′s t test or Chi-square test depending on different data types. Multivariate logistic regression analysis was employed to analyze the risk factors for ST-segment shift and prolongation and T-wave changes. Results There were significant differences in body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), total bilirubin (TBIL), direct bilirubin (DBIL), uric acid (UA), homocysteine (Hcy), history of drinking and incidence rates of ST-segment shift and prolongation and T-wave changes between two groups (all P<0.05). In the Kazak group, the incidence of ST-segment and T-wave changes was increased with 10 years of age increase. Multivariate logistic regression analysis showed that age increased by 10 years, increased BMI, SBP, DBP, TC, LDL-C, UA and Hcy levels, decreased TBIL and DBIL levels and history of alcohol drinking were independent risk factors for ST-segment shift and prolongation and T-wave changes in Kazakh group (P<0.05). Conclusion The detection rate of ST-segment shift and prolongation and T-wave abnormality in Kazak people is quite higher than that of Han people. The risk factors of abnormal changes are age increase of 10 years, obesity, abnormal blood pressure and biochemical indicators. Attention should be paid to the abnormal changes of ECG in the population, and combining biochemical examination and clinical data has an important clinical value for screening ischemic heart disease.