Objective To investigate the effects of standardized secondary prevention on lifestyle of patients with acute coronary syndrome. Methods Two hundred and forty-nine patients with acute coronary syndrome were randomly divided into standardized follow-up group (n=116) and routine follow-up group (n=133). Patients in standardized follow-up group were followed up every 3 months, and lifestyle education of secondary prevention was carried out during the follow-up, including smoking quitting, exercise, body weight control, drug use standardization and pressure regulation. Patients in routine follow-up group were followed up every 6 months. At the time points of 6 months of follow-up and 1 year of follow-up, the conditions of smoking quitting, exercise, body weight control and ultimate events (cardiac death, non-lethal myocardial infarction and revascularization of targeted vessels) were compared between groups. Results Two hundred and eighteen patients completed the 6-month follow-up, and 103 patients finished the 1-year follow-up. After follow-up for 6 months or 1 year, the percents of unsuccessful smoking quitting in standardized follow-up group were significantly lower than those in routine follow-up group (P<0.01), and the percents of successful exercise in standardized follow-up group were significantly higher than those in routine follow-up group (P<0.05 or P<0.01). One year after follow-up, the percent of overweight in standardized follow-up group was significantly lower than that in routine follow-up group (P<0.05), and there was no ultimate event in both groups. Conclusion Standardized follow-up can effectively improve the lifestyle of patients with acute coronary syndrome.