The survival of a cohort of 736 patients (617 men and 119 women) with a first acute myocardial infarction is reported. All patients were admitted and diagnosed at a referral center of six areas of the province of Girona, Spain. The results of a follow-up period of 10 years are analyzed. The overall 10-year survival rate was 55% (57% in men and 43% in women). The survival curves for males and females were significantly different (p = 0.0001). In the acute phase of infarction, the mortality amongst women was higher than amongst men. Women suffered from myocardial infarction at an older age than men. When the study population was stratified by age groups, no statistically significant differences in the survival rates between men and women were observed. We conclude that age is the confounding variable that all other survival-related variables have to be adjusted for. Sex was not found to be a determinant factor for long-term survival after myocardial infarction. The worse hemodynamic condition amongst women prior to the infarction may account for the greater mortality in the acute phase observed in females.