Objective To investigate Grace score, TIMI score in the evaluation the outcome of adverse events in patients with undifferentiated chest pain admitted to the emergency department.Outcomes included emergency admission, emergency coronary artery interventional therapy, 30 days of death and other cardiovascular adverse event prediction.Methods Retrospective analysis of the clinical data of 536 patients with acute chest pain in Beijing An Zhen Hospital emergency department during 2008.02 to 2010.02, calculate the baseline level of Grace, TIMI score in patients, and the 30 day prognosis were followed up.To determine the independent predictors of cardiovascular emergency patients with acute chest pain, univariate analysis and Logistic regression of emergency PCI, 30d death and other adverse events were analysised.Score and outcome were compared using ROC analysis.Results The average age of patients with chest pain in the emergency department is 55.7 ± 12.7 years, emergency admission in 319 cases (59.5%); 30 days of death in 45 cases (8.4%).Compared with TIMI risk score, Grace risk score can independently predict acute hospitalization (OR: 1.02, 95%CI:1.01-1.03, p=0.01), 30-d death (OR: 1.05, 95% CI:1.04-1.07, p<0.01) and emergency PCI (OR: 1.02, 95% CI:1.01-1.03, p<0.01) risk;also which ROC of hospitalization rate(0.873, 95% CI: 0.843-0.903), 30-day mortality(0.654, 95% CI: 0.573-0.736), PCI(0.746, 95%CI: 0.705-0.787) rate and other MACE events(0.651, 95%CI: 0.577-0.725) was statistically significant (P<0.01); The Grace risk score were more sensitive than the TIMI rik score in predicting.Conclusion Compared with the TIMI score, Grace score can be more effective to determine the death rate at 30 days, the prognosis of emergency PCI in emergency patients with acute chest pain.