Abstract： Objective:To summarize the image characteristics of echocardiography on myocardial infarction combined with ventricular septal rupture.Methods:This study wass a retrospective cohort study, a total of 132 myocardial infarction patients with ventricular septal rupture treated who received in the department of Cardiovascular Medicine in the General Hospital of Northern Theater Command from December 2016 to January 2024, including 64 males and 68 females, aged(69.34±7.75) years old, ranging from 43 to 90 years old.Echocardiography was used to observe the ventricular septal perforation, the relationship between ventricular septal perforation size and hemodynamics, and the location of the ventricular septal defect in myocardial infarction.Results:The onset age of female patients[(69.34±7.75)years old]was higher than that of male patients[(64.52±9.05)years old], the difference was statistically significant( P<0.05).A total of 110 cases of extensive anterior/anterior wall myocardial infarction were found, apical defect were 59.1%(71/110), were anterior ventricular septal defect were 36.4%(40/110) and posterior ventricular septal defect were 4.5%(5/110), among 22 cases of inferior and posterior wall myocardial infarction, apical defect type was 9.1%(2/22), posterior ventricular septal defect type was 90.9%(20/22).The incidence of ventricular septal perforation in single-hole type was 93.9%(124/132), multi-hole type was 6.1%(8/132), apical ventricular septal defect was 71.2%(94/132) and posterior ventricular septal defect was 19.7%(26/132), anterior ventricular septal defect type was found in 9.1%(12/132).The incidence of ventricular aneurysm was 77.3%(102/132).LVEDD of 10 mm≤perforated<15 mm patients[(51.36±5.25)mm]was higher than 5 mm≤perforated<10 mm patients[(49.35±4.37)mm]; right ventricular dimension of 15 mm≤perforated<20 mm patients[(19.88±1.80)mm]was higher than 5 mm≤perforated<10 mm patients[(17.46±2.40)mm]; left ventricular ejection fraction of 10 mm≤perforated<15 mm patients(0.43±0.07) was lower than perforated <5 mm patients(0.52±0.04), the differences were statistically significant( P<0.05). Conclusions:Echocardiography can evaluate the ventricular septal perforation site, number, size, and cardiac function, and the perforation site can predict the coronary artery lesion site to some extent.