Background: Among aged patients, acute myocardial infarction has more complications and there is a tendency to underuse proven treatments. Aim: To report the features of acute myocardial infarction among aged patients. Material and Methods: Analysis of a registry of patients with acute myocardial infarction admitted to a coronary unit. For the purposes of analysis, patients aged 65 years or more were selected. Follow up was made consulting medical records, calling patients by telephone or consulting death records at the National Identification Service. Results: A total of 1.358 patients were admitted in the study period with a diagnosis of acute myocardial infarction and 580 (43%) were aged 65 years or more. On admission, this age group had a higher frequency of hemodynamic instability and anterior wall infarctions. Reperfusion therapy and beta blockers were used less commonly in this group. Hospital mortality among patients younger or older than 65 year was 8 and 25%, respectively (p<0.01). Among aged patients, five years mortality was 33%. Conclusions: Among aged patients, acute myocardial infarction has a higher risk profile on admission, is usually undertreated and has higher mortality than younger subjects.