As men are aging, their testosterone levels decline, while the morbidity of atherosclerosis (AS) rises in accordance with their age. Recent studies indicate that inflammation contributes to atherosclerosis. Whether hypogonadism in old men is associated with inflammation deserves to be investigated.Background. To examine the relationship between free testosterone (FT) and inflammatory cytokines such as pregnancy-associated plasma protein A (PAPP-A), interleukin-6 (IL-6), vascular cell adhesion molecule-1 (VCAM-1), intracellular adhesion factor-1 (ICAM-1) in old men with acute coronary syndrome (ACS).Methods. Serum was collected from 107 men aged 60-86 years. Among them, 52 were patients with ACS. The relationships between FT and PAPP-A, IL-6, VCAM-1 and ICAM-1 were examined respectively.Results. Levels of weight, body mass index, total cholesterol, low density lipoprotein cholesterol, triglyceride, PAPP-A, IL-6, VCAM-1 and ICAM-1 of old male ACS patients were higher than those of controls; FT and high density lipoprotein cholesterol levels were lower than those of controls. FT level was inversely associated with PAPP-A, IL-6, VCAM-1 and ICAM-1. Conclusions. FT level is inversely associated with inflammatory cytokines such as PAPP-A, IL-6, VCAM-1 and ICAM-1 in old men with ACS. This might imply that low testosterone is associated with inflammation in old men with ACS.