【Objective】To investigate the effect of GRACE scores on prediction of 30-day cardiovascular adverse events in acute chest pain patients.【Methods】A prospective，observational analysis was conducted in the patients with acute chest pain in Emergency Department（ED）from January 1，2016 through April 1，2016. Data including characteris? tics and GRACE scores were collected. All causes leading to MACE were followed up at 30th day after the onset of acute chest pain.【Results】Among a total of 209 patients presenting with acute chest pain enrolled in this study，110 were male （52.63%）and 99 were female（47.37%）. The range of age was 20-98years old，and mean age was（65.28±16.85）years old. During follow-up period，12 patients had MACE，2 patients died in ED，3 patients died in hospital，6 patients died out of hospital，and 1 person was diagnosed with myocardial infarction. When compared with non-MACE group，factors including age，BMI，hospitalized patient number，and number of patients admitted in CCU as well as GRACE scores， were significantly higher in MACE group（P<0.05）. The predictive ROC curve area of GRACE scores in 30-day MACE was 0.819（0.735 to 0.902）. The optimal sensitivity and specificity were 0.92 and 0.65，respectively. The probability of 30-day cardiovascular adverse events in various GRACE score risk stratification was 0.95%（low-risk），6.67%（medi? um-risk），and 18.92%（high-risk），respectively.【Conclusion】The GRACE score was a useful predictor to the occur? rence of 30-day cardiovascular adverse events in acute chest pain patients.