In the first report from southern Saudi Arabia, we studied retrospectively 124 patients admitted to Asir Central Hospital, Abha, with proved acute myocardial infarction. There were 116 men (94%) and 98 patients were Saudi (79%). The majority of non-Saudi patients were Egyptians and Pakistanis. The mean age was 57 (SD = 13) years. Diabetes mellitus, cigarette smoking, and hypercholestrolemia were the most common risk factors. Most of the patients had anterior acute myocardial infarction and, remarkably, both the incidence of complications and the mortality rate were lower than those reported from the rest of Saudi Arabia and the western world. A possible explanation for this trend, among others, could be prolonged residence at high altitude, which may have acted as a protective factor to the myocardium.