Objective: To analyze the clinical characteristics of severe sepsis complicated with acute myocardial infarction (AMI) in patients with severe respiratory diseases. Methods: The clinical data of 12 patients with severe sepsis complicated with AMI admitted to the department of pulmonary and critical care medicine from January 2016 to February 2021 in our hospital was retrospectively analyzed. Results: Of the 12 patients, ten were males and two were females, with a median age of 81 years (ranging from 63 to 89 years). More than half of the patients had history of hypertension or chronic respiratory diseases and all patients developed significant hypoxia before AMI occurrence. On the day of AMI occurrence, the proportion of patients with symptoms of elevated heat peak, oxygenation deterioration, decreased blood pressure, and chest tightness and dyspnea were 10/12, 9/12, 7/12, and 6/12, respectively. The symptoms of decreased blood pressure and oxygenation deterioration simultaneously happened in seven patients. The proportion of T wave inversion, Q wave, ST-segment depression, and ST-segment elevation in electrocardiogram were 6/12, 4/12, 4/12, and 3/12, respectively. In all AMI sites, apical segment and middle segment of inferior AMI accounted for 8/12 respectively. Additionally, the apical segment and middle segment of anterior AMI accounted for 7/12 and 6/12, respectively. The interval in all patients from severe sepsis occurrence to AMI development was 1 to 2 days. All patients were treated conservatively because of their critical conditions, and nine of them died finally. Conclusion: AMI may develop in patients with severe respiratory diseases in a short interval after severe sepsis occurrence with symptoms of elevated fever peak, decreased blood pressure, and oxygenation deterioration. The prognosis of these patients was very poor. T wave inversion, Q wave, and ST segment depression were the main changes in electrocardiogram. Inferior and anterior myocardial infarction were common in this sepcial population.