Acute myocardial infarction due to acetaldehyde syndrome has been rarely reported. A 22-year-old, chronic alcoholic man was admitted to our hospital with typical angina pectoris that developed after oral intake of disulfiram and alcohol together. The electrocardiogram showed hyperacute inferior myocardial infarction and he was successfully treated by thrombolytic therapy. Coronary angiogram revealed normal coronary arteries; thus, the event was probably secondary to coronary artery thrombosis and/or coronary vasospasm. Disulfiram is not a safe drug in patients unable to adhere to the strict restriction of alcohol intake, requiring a close supervision of individuals on disulfiram therapy.