We assessed the impact of preprocedural high-sensitivity C-reactive protein (hsCRP) on the incidence of contrast-induced nephropathy (CIN) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (p-PCI). We retrospectively studied 1452 patients with STEMI undergoing p-PCI. Baseline clinical characteristics, CIN incidence, and other inhospital clinical outcomes were compared among hsCRP quartiles; 212 (14.6%) patients developed CIN. The overall inhospital mortality rate was 4.5% (65 patients). Univariate analysis revealed CIN incidence was significantly associated with hsCRP, with 7.44% for quartile Q1 (< 3.00 mg/L), 12.6% for Q2 (3.00-5.90 mg/L), 16.9% for Q3 (5.91-11.4 mg/L), and 21.49% for Q4 (> 11.4 mg/L; P < .001). Patients with a higher hsCRP experienced a higher rate of inhospital complications. After adjusting for potential confounders, hsCRP > 6.50 mg/L was significantly associated with the occurrence of CIN. Preprocedural hsCRP levels are significantly related to the incidence of CIN in patients with STEMI undergoing p-PCI.