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Abstract: Aims of the study: The study evaluated in-hospital and long-term outcome of patients less than 50 years old with myocardial infarction within 12hours after symptom onset treated by coronary angioplasty. Patients and method: This is a retrospective study with survival analysis by Kaplan-Meier method in patients included from December2003 to February2008. Results: We included 93 patients aged 42,8±5,2 years old with smoking estimated at 27,7±12,7 pack-years. Thirty-one patients (33,3%) were dyslipidemic and 36 patients had family history of coronary artery disease. Thirty patients (32,3%) had an anterior myocardial infarction and four patients (4.4%) had Killip greater than 2. Coronary angioplasty was performed within 4.5±3.0hours after symptom onset with TIMI 3 final flow in the culprit vessel in 96.8%. One patient died from cardiogenic shock. With a follow-up of 85 patients during 20.0±15.6 months, the survival without death was 98.2% and survival without major cardiac complication was 87.9% at 24months. Seventy-two patients (85.7%) were taking a betablocker, 81 patients (96.4%) aspirin, 75 patients (89.3%) a statin and 64 patients (76.2%) an angiotensin-converting inhibitor. Only 50 patients (58.8%) were nonsmokers. Conclusion: Thus, young smokers with acute MI treated by coronary angioplasty have a good prognosis during in-hospital stay and long-term outcome. Secondary medical treatment prevention is well followed but there is a low rate of smoking cessation. [Copyright &y& Elsevier]