〔Abstract〕 Objective To study the effect of dynamic electrocardiogram (DCG) in patients with acute coronary syndrome (ACS). Methods A total of 85 suspected ACS patients admitted and diagnosed by Shaodong People's Hospital from December 2017 to December 2019 were selected. All patients were detected by ordinary electrocardiogram (ECG), coronary angiography (CAG) and DCG, and the application effects were compared. Results For all patients, CAG, ECG and DCG were 77 cases, 65 cases and 72 cases, respectively. The sensitivity, specificity and accuracy of DCG in diagnosing ACS were 89.61%, 62.50% and 87.06%, respectively, which were significantly higher than those of ECG (75.32%, 12.50% and 69.41%), with statistical significance (P < 0.05). For 77 ACS patients with definite diagnosis of CAG, the total detection rate of multiple lesions in DCG was significantly higher than that in ECG, and the difference was statistically significant (P < 0.05). There was no significant difference in the total detection rate of the remaining lesions of DCG and ECG (P > 0.05). Conclusion DCG has a significant diagnostic effect on ACS patients.