This meta-analysis of oral contraceptive use in relation to myocardial infarction is based on 19 case-control studies and 4 cohort studies that met pre-stated inclusion criteria. A comprehensive literature search was performed using the MEDLINE computerized database (for studies from January 1966 through October 2002). In addition, a manual search was performed for references cited in published original and reviewed articles. Current oral contraceptive (OC) users have an overall adjusted odds ratio (OR) of myocardial infarction (MI) of 2.48 [95% confidence interval (CI): 1.91-3.22] compared to never-users. The risk of MI for past OC users is not significantly different from that for never-users, overall OR = 1.15 (95% CI: 0.98-1.35; p = 0.096).