During the last 2 decades researchers have developed a clearer understanding of the pathophysiology of acute myocardial infarction (AMI). The use of thrombolysis and coronary angioplasty early in the course of AMI salvages myocardium and preserves left ventricular function, which results in improved survival rates. Late reperfusion after AMI, however, may provide beneficial effects on long-term prognosis, especially owing to attenuation of left ventricular remodeling. This article reviews the evidence of the benefits of an open infarct-related artery on left ventricular remodeling after AMI.