It was controversial that deferred stenting strategy could reduce no-reflow phenomena or major adverse cardiovascular events(MACEs)in primary percutaneous coronary intervention(PCI)for patients with ST-segment elevation myocardial infarction(STEMI).Methods A total of 513 STEMI patients with high thrombus burden were retrospectively enrolled from January 2015 to January 2020.These patients were divided into two groups:experimental(with deferred stent implantation strategy,n=118)and control group(with immediate stent-ing strategy,n=395).The primary endpoint of this study was the incidence of no-reflow events.The secondly end-points the in-hospital MACEs and one-year follow-up.Results The baseline characteristics were compared be-tween the two groups.The occurrence of no-reflow phenomenon was significantly lower in the experiment group than the control group(16.9％vs.23.8％,P=0.035),which was mainly driven by the slow-flow(13.5％in experi-ment group vs.17.2％in control group,P=0.041).No significant difference was found between two groups in terms of in-hospital adverse events.The experiment group was associated with lower MACE rate than the control group(8.5％vs.15.7％,P=0.013)at one-year follow-up.Conclusions Deferred stenting had potential effect to reduce the risk no-reflow phenomenon in STEMI patients with high thrombus burden.This method was relatively safe and was associated with better clinical outcome.