Heart disease has been the third place of the top ten cause-of-death of our country in recent years. Amongst the acute myocardial infarction has the highest mortality rate. However, the mortality rate of AMI can be lowered should the appropriate medical treatments could be given in appropriate time. Therefore, the purpose of this study is to retrospectively investigate the relation between the compliance of clinical indicators of AMI inpatient and medical quality and medical expenses. Our study found that the numbers of compliance items in clinical guidelines are statistically significant in association with the complications, mortality rate, and readmission in 30 days. And we did not find the significance in length of stay and medical expenses. The age of AMI patients is significantly associated with expenses. And the female is significantly higher than the male patients in length of stay. The average length of stay, medical expenses, and complications significantly has the variation among the three studied hospitals in the same multi-hospital system. In conclusion, complying with evidence-based AMI clinical guideline can reduce the mortality of AMI patients and medical expenses. It is recommended that we should greatly promote clinical practice guideline in medical care and improve medical quality, and maximize the effort of medical expenses.