Individuals with cardiovascular diseases (CVDs) are at increased risk for morbidity and mortality from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although vaccinations should be a priority for individuals with high-risk CVDs, some may be hesitant to pursue such interventions. This cross-sectional study was designed to document the prevalence and correlates of COVID-19 vaccine hesitancy among myocardial infarction (MI) patients in China. Participants diagnosed with MI were recruited from Beijing Anzhen Hospital between October 17, 2021 and May 17, 2022. The primary outcome was prevalence rate of COVID-19 vaccine hesitancy. Demographics and attitudes toward vaccination were also assessed as potential correlates of vaccine hesitancy. A total of 565 MI patients were consecutively included for analyses. The percentage of participants that reported vaccine hesitancy was 32.7% (95 %CI: 28.9–36.6%), while 67.3% (95 %CI: 63.4–71.1%) viewed COVID-19 vaccines as safe and without serious side effects. MI patients who were married (OR = 0.47, 95 %CI: 0.23–0.95) and those who thought vaccines were safe (OR = 0.44, 95 %CI: 0.28–0.68) were less likely to report vaccine hesitancy. Conversely, participants who were older (OR = 1.04, 95 %CI: 1.02–1.07) and those who worried about being infected with COVID-19 (OR = 2.03, 95 %CI: 1.35–3.03) were more likely to be vaccine hesitant. A relatively high rate of vaccine hesitancy was found in Chinese MI patients. Immunization remains the leading strategy for reducing the health burden of COVID-19 in vulnerable groups including MI patients. Improving awareness of benefits of COVID-19 vaccines and emphasizing their safety could alleviate potential concerns of vaccine-hesitant MI survivors.