Although the benefits of primary angioplasty for acute myocardial infarction have been demonstrated, several areas for improvement remain. The initial results of randomized trials have shown that primary stenting for acute myocardial infarction is feasible and effective with a low complication rate. Primary stenting results in a reduction in recurrent infarction and in the need for subsequent re-intervention, when compared to balloon angioplasty. Whether long-term clinical and angiographic outcome is also favourable has yet to be confirmed in large-scale multicentre trials, before primary stenting can be adopted as routine approach for acute myocardial infarction.