Abstract: OBJECTIVE To observe the effects of recombinant streptokinase (r-SK) and urokinase (UK) in treatment of acute myocardial infarction through intravenous thrombolysis. METHODS The 186 patients were randomly divided into Group r-SK (96 patients) and Group UK (90 patients).The patients of the both groups were given conventional therapy: Group r-SK was treated with r-SK (1 500 000 units) plus glucose solution (5%, 100 mL), while Group UK was treated with UK (1 500 000 units) plus glucose solution (5%, 100 mL). After that, the coronary recanalization rate, adverse reactions and mortality in 5 weeks were observed. RESULTS For Group r-SK, the general recanalization rate of is 81.25%, the recanalization rate in 6 hours is 85.14%, and the recanalization rate in 6-12 hours is 68.18%, each of which is significantly different from that of Group UK (P<0.05). However, there is no significant difference in bleeding, arrhythmia, allergy, low blood pressure and mortality after five weeks between the two groups (P>0.05). CONCLUSIONS Compared to UK, r-SK can achieve a higher rate of recanalization of myocardial infarction vessels, better treatment effect, and fewer adverse reactions and complications, so it's worth promoting in clinical treatment.