Objective To compare the safety and efficiency of pacemaker implanting by subclavian vein versus axillary vein. Method Patients were divided into two groups: implating pacemaker by subclavian vein( common group,n =276) and implating pacemaker by axillary vein( uncommon group,n = 276). Results The success rate of puncture were similar between the two groups( P0.05). The incidence of pneumothorax was lower in uncommon group compared to that in common group( 0.36% vs 1. 81%,P 0. 05),but the time of X-ray exposure was longer in uncommon group compared to that in common group[( 83.51± 29.09) s vs( 10.72± 30.47) s,P 0.05) ]. Conclusion The safety of pacemaker implanting by subclavian vein was worse than those by axillary vein,but the efficiency was similar between the two groups.