Ｏｂｊｅｃｔｉｖｅ　To investigate the impact of initial dose epinephrine in different administration routes on the successful rate and the short-term prognosis of cardiopulmonary resuscitation （CPR）.　Methods　From december 2007 to december 2013, 246 patients with cardiac arrest who received CPR were retrospectively analyzed. According to the different administration routes of initial dose epinephrine during CPR， 264 patients were randomly divided into 3 groups： peripheral venous （PV） group （group PV）， central venous （CV） group （group CV） and intracardiac injection （ICI） group （group ICI）. The rate and time of spontaneous circulation restoration， the times of electric defibrillation， the dose of epinephrine，and complications of the intracardiac injection were recorded. Then the survival rates of 1， 24 h after CPR and out of hospital were recorded. Retrospective analysis was carried out.　Results　The rate of spontaneous circulation restoration in group PV， CV and ICI were 36.5%， 39.0% and 43.9% respectively. The time of spontaneous circulation restoration in group PV， CV and ICI were（6.8±1.3），（5.5±1.5） min and（4.1±1.1） min， the times of electric defibrillation were （5.0±1.5），（4.0±1.2） min and （3.0±1.3） min， the dose of epinephrine were （7.5±1.8）， （6.3±1.2） mg and（5.0±1.5） mg in group PV， CV and ICI. The survival rates of 1， 24 h after CPR and out of hospital were 34.1%， 30.4% and 25.6% in group PV， 36.5%， 24.4% and 24.3% in group CV， 40.2%， 9.0% and 25.6% in group ICI. Among the three groups， there was obviously higher rate and shorter time of spontaneous circulation restoration（P＜0.05）， distinctively less times of electric defibrillation and less dose of epinephrine（P＜0.05） in group ICI. And the survival rates of 1 h and 24 h after CPR were apparently higher（P＜0.05） in group ICI. One case occurred pericardial hemorrhage with more than 50 ml lost and pericardiocentesis and drainage was performed timely. The survival rates out of hospital of the three groups were no significant statistical differences. Conclusions　An intravenous route of administration was not readily available when cardiac arrest， intracardiac injection of initial dose epinephrine could effectively improve the rate of cardiopulmonary resuscitation.