Acute myocardial infarction (AMI) is a serious condition which requires rapid hospital management. In this article, we review the current recommendations concerning AMI treatment, as well as our therapeutic approach, which is based on the evidence provided by several large well controlled clinical trials. Mid and long term prognosis are mainly related to the development of left ventricular dysfunction which determines heart failure, the occurrence of severe ventricular arrhythmias and the persistence of residual myocardial ischemia. Several treatments (aspirin, beta-blockade, ACE inhibitors, statins) have shown their benefit in terms of secondary prevention.