Objective: To explore the diagnostic value of vectorcardiography (VCG) combined with color Doppler echocardiography (CDE) for acute inferior myocardial infarction (MI) culprit vessel.Methods: A total of 82 patients who had been clinically diagnosed as acute inferior MI and had received coronary arteriography (CAG) were selected as research objects. They received bedside VCG and CDE examinations after admission. Their culprit vessels were analyzed and compared with CAG results to evaluate the diagnostic efficiency.Results: The detection rate of acute inferior MI culprit vessel by VCG combined with CDE was 76.83%, including 18 left circumflex (LCX) branches and 45 right coronary arteries (RCA). The lower left constituent ratio of LCX was 61.11%, which was significantly higher than 20.00% in RCA (p < .05); the lower right constituent ratio of RCA was 71.11%, which was much higher than 11.11% in LCX (p < .05); the sensitivity and the accuracy of RCA culprit vessel judged with frontal plane ST-vector pointing to the lower right quadrant were 71.11% and 53.33% respectively; the diagnostic efficiency of LCX culprit vessel judged with frontal plane ST-vector pointing to the lower left quadrant was 61.11% and 50.00% respectively. The maximum amplitude of the frontal plane in LCX culprit vessel was significantly lower than that in RCA culprit vessel; and the frontal plane vector angle in LCX was significantly greater than that in RCA culprit vessel (p < 0.05).Conclusions: VCG combined with CDE can effectively diagnose acute inferior MI. It has a good diagnostic efficiency by judging culprit vessels according to the frontal plane ST-vector direction.