Primary revascularization (PR) and thrombolytic therapy (TT) reduce infarct size and mortality in patients with ST-segment elevation acute myocardial infarction (AMI). Electrocardiogram methods can determine the extent of myocardial salvage with different AMI therapies by comparing infarct size predicted by initial ST-segment changes and infarct size estimated by later quantitative QRS scores. In a community hospital setting, we used quantitative electrocardiogram methods to estimate infarct size and myocardial salvage associated with TT and PR amongst 50 patients presenting with inferior ST-segment elevation AMI. Baseline and electrocardiogram characteristics did not differ between TT (n = 29) and PR (n = 21) patients. There was no difference in median myocardial salvage (%) between TT vs. PR groups, (38.3% vs. 44.9% respectively, P =.66). Among patients with inferior AMI, myocardial salvage was achieved with both TT and PR therapy and did not differ significantly between reperfusion strategies.