Streptococcus suis (S. suis) infection, a zoonotic infection with a global distribution, is clinically manifested by meningitis, followed by sepsis, infective endocarditis and arthritis. S. suis infection is not uncommon, but acute myocardial infarction (AMI), as an initial symptom, has not yet been reported. We report a case of S. suis infection with AMI as an initial symptom. The patient, a previously healthy butcher with no known risk factors for AMI, was admitted to hospital with a sudden onset of AMI. Then, thrombolytic therapy, anticoagulation therapy with nadroparin calcium and antiplatelet therapy with aspirin and ticagrelor were adopted. Two days later, blood cultures in aerobic and anaerobic bottles were positive for S. suis and he received antibiotic therapy with piperacillin/tazobactam. Then, his symptoms improved and he was transferred to a special infectious disease hospital for further treatment and was discharged upon complete recovery. To the best of our knowledge, this is the first reported case of AMI as the initial symptom of S. suis infection, which illustrates a possible new symptom of this important pathogen. For AMI patients with unexplained infections, and who are in close frequent contact with pigs and/or pork products, clinicians should be alert to the possibility of S. suis infections.