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Background: Recently, the death due to infecticn is decreasing, but the death due to macroangiopathy such as caronary artery disease is increasing in Karean diabetics. So, this study was done to evaluate the clinical characteristics of acute myocardial infarction in diabetics. Methods: The medical records of 194 cases with acute myocardial infarction (Diabetics: 64 cases, non-diabetics: 130 cases) were reviewed from March, 1993 to February, 1995 at major hospitals in Pusan, Korea. Results: 1) The mean age was higher in diabetics(63,2+9,1 years) compared with non-diabetics(59.9+11.6 years) and male to female ratio was lower in diahetics(male: female 1.1:1) compared with non-diabetics(male: female 1.1:1)(p<0.05). 2) lhe incidence of silent myocardial infarcticn was higher, even thaugh not significant in diabetics(29.7%) than in non-diabetics(13.1%). 3) Among corconary risk factors, the fiequency of hypertension and smoking were higher in non-diabetics(44%, 49% respectively) than in diabetics (30%, 22% raspectively)(p<0.05). 4) There was no significant difference between the two groups in the frequency of non Q wave infarction, locaticn of infarction and presence of the old myocardial infarction. 5) Among the complications of myocardial infarction, the frequency of congestive heart failure was significantly higher in diabetics(48.4%) than in non-diabetics(27.7%), and that of arrhythmia was higher in diabetics(32.8%) than in non-diabetics(21.5%) but nat significant. 6) The mortality rate was higher, though not significant in diabetics(17.2%) than in non-diabetics(9.2%). Conclusion: The diabetes mellitus is an independent risk factor of acute myocardial infarction and the prognosis of acute myocardial infarcticn is poorer in diabetics than in non-diabetics. Therefore, clinicians need to take extra care in the diagnosis and management of myocardial infarction in diabetics.