Objective To investigate the clinical effect of dynamic electrocardiogram in the diagnosis of paroxysmal ventricular tachycardia (PPVT). Methods 90 patients with PPVT were selected for dynamic ECG detection. According to the waveform characteristics, they were divided into group A (right ventricular origin, n = 48) and group B (left ventricular origin, n = 42). Results There was no significant difference in mean ventricular rate, QTcd, QRS time limit and the incidence of ST-T segment changes between the two groups (P > 0.05); The QRS axis of group A was smaller than that of group B, and the difference was statistically significant (P < 0.05); ST-T segment changes were 81.25% in group A and 76.19% in group B. logistic regression analysis showed that QRS axis was a risk factor for PPVT (or > 1, P < 0.05). Conclusion Dynamic electrocardiogram has high value in the diagnosis of PPVT. QRS axis is a risk factor for PPVT. Measuring QRS axis can identify the origin of ventricle, which is conducive to the early diagnosis and treatment of the disease.