Triglyceride glucose-body mass index (TyG-BMI) is an indicator of insulin resistance (IR) and is associated with an increased risk of adverse cardiovascular events. Insulin resistance (IR) is an important pathogenesis of diabetes mellitus, and also an important factor affecting the incidence and prognosis of cardiovascular diseases. However, the relationship between TyG-BMI and CIN in patients with STEMI has not been studied. STEMI patients who underwent percutaneous coronary intervention (PCI) between January 2017 and July 2020 were selected consecutively. The occurrence of contrast-induced nephropathy (CIN) is determined by the serum creatinine concentration. A total of 1041 patients (813; 78.1% male) with STEMI who underwent primary PCI were enrolled in this retrospective study. The registered cohort was divided into 2 groups according to whether the subjects developed CIN after surgery. CIN was defined as an increase in serum creatinine > 25% or 0.5 mg/dL from baseline in the first 48 to 72 h after PCI. A total of 201 cases (19.3%) of CIN were diagnosed. Compared with CIN (-) patients, CIN (+) patients had larger BMI, higher proportion of hypertension and hyperlipidemia, higher levels of fasting blood glucose, total cholesterol, triglyceride and uric acid, and higher levels of metabolic score for insulin resistance (METS-IR), triglyceride-glucose index (TyG) and TyG-BMI. Multivariate logistic regression analysis showed that TyG-BMI (OR = 1.029,95%CI 1.011-1.047, P = 0.002) were the independent risk factors for CIN in STEMI patients after primary PCI. ROC curve analysis showed that TyG-BMI had a high predictive value for CIN (AUC = 0.812; 95%CI 0.784-0.840), the best cut-off value was 196.34, the sensitivity was 85.6%, and the specificity was 73.1%. TyG-BMI is an independent risk factor for CIN after pPCI in STEMI patients and has a good predictive effect for the occurrence of CIN after pPCI.