The characteristic ECG of de Winter syndrome is up-slope ST-segment depression with symmetric high apex of T wave, which quickly progresses to ST-segment elevation myocardial infarction. Such ECG pattern should be identified early and emergency reperfusion therapy saves the patient's life. We report a 10-year-old child with early ECG manifestations of de winter. Combined with the dynamic changes of myocardial enzymes and troponin, the coronary angiography examination was perfected with emergency interventional therapy.