Coronary artery ligation is widely used for myocardial infarction (MI) induction in rats but produces a large variation in infarct size--a major determinant of mortality. Accurate control of infarct size is critically important for the establishment of a useful animal model. This study determined the anatomical course of the left anterior descending coronary artery (LAD) by direct visualization in order to locate precisely the position of ligation. MI was induced by conventional methods (control group) or using a detailed anatomical knowledge of the LAD (experimental group). Triphenyltetrazolium chloride (TTC) staining was performed to compare infarct size, and electrocardiogram (ECG) changes were observed. The rate of MI induction was significantly higher in the experimental group than in the control group (89.5% vs 65.6%) and the size of infarction was more consistent in the experimental group. Direct visualization of the rat LAD allowed accurate identification of the ligation site, thereby controlling infarct size and improving the success rate of the rat model.