Background: Some patients with acute carbon monoxide (CO) poisoning will experience cardiac failure. Although many previous reports demonstrated mechanisms of cardiac toxicity in acute CO poisoning, reports on epidemiology and clinical characteristics of CO induced cardiomyopathy have been limited and not elucidated. The aim of study was to investigate epidemiology, clinical characteristics, and prognosis of CO induced cardiomyopathy in patients with acute CO poisoning. Methods: A retrospective chart review was conducted on consecutive patients who visited to an emergency medical center, diagnosed as acute CO poisoning during a period of 62 months. A standardized extraction using medical records such as demographic, clinical, laboratory, and radiological data was performed on selected patients. The definition of CO induced CMP was as follows in the present study: 1) Transient hypokinesis, akinesia, or dyskinesis of the left ventricular midsegments with or without apical involvement after acute CO poisoning 2) the regional wall motion abnormalities extending beyond the geographic territory of a single epicardial artery, 3) absence of obstructive atherosclerotic coronary artery stenosis (<50% luminal narrowing of the epicardial artery), 4) New ECG abnormalities or modest elvevation in cardiac troponin. 5) complete recovery of regional wall motion abnormalities. Results: Among of 626 patients diagnosed as acute CO poisoning from July 2008 and August 2013, Echocardiography was performed on 84 patients: 65 patients were normal, and 19 patients were abnormal - global hypokinesia in 14 patients and any regional wall akinesia in 5 patients. In terms of ejection fraction, > EF 45% in 70 patients, < EF 45% in 14 patients. CO induced cardiomyopathy was identified in 19 patients. The gender ratio was 1: 0.73 (male: female), mean age was 42.6±21.1. At initial echocardiography, EF was 36.3± 13.5 (range 15% to 55%). Eleven patients underwent follow-up echocardiography had return to normal EF (≥ 50%), which was performed within 12 days from the time of initial echocardiography. Conclusion: CO induced cardiomyopathy was identified in 3.04% (n=19) of total patients (n=626) in the present study. When complete recovery from CO induced cardiomyopathy considered, the prognosis of CO induced cardiomyopathy was good. Therefore, the importance of CO induced cardiomyopathy was not significant by itself in clinical course of acute CO poisoning. Considering also the common denominators between Takotsubo cardiomyopathy and CO induced cardiomyopathy, we speculated that the injury mechanism of both diseases was seemed to be same as stunned myocardium due to catecholamine surge in myocardial synapses.