Objective To carry out a retrospective analysis of the correlation between high-density lipoprotein cholesterol (HDL-C) and intracoronary thrombus burden. Methods and results A total of 270 patients with ST-segment elevation myocardial infarction undergoing primary PCI were analyzed retrospectively. They were divided into two groups: patients with (group A, n = 111) and patients without (group B, n = 159) angiographic characteristics of thrombus. The results showed that the level of HDL-C was markedly lower in group A than that in group B. The logistic regression analysis of the relationship between multiple factors showed that only the level of HDL-C was correlated negatively with the angiographic characteristics of thrombus. Conclusion HDL-C is correlated with the angiographic presence of thrombus. Coron Artery Dis 24:1-5 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins. Coronary Artery Disease 2013, 24:1-5