ACS's revascularization delays remain a challenge in our country where cath-labs are not sufficiently numerous. Our hospital (Berrouaghia) is located 110 km south of Algiers and 60 km (100 min) from the nearest cath-lab (teaching hospital of Blida). Improved coronary care requires the development of a coronary care network based on the health characteristics of the region. A prospective, monocentric study conducted from October 1, 2015 to March 31, 2017, covering all patients admitted with ACS, we analyzed delays of revascularization in situ (fibrinolysis) and remote (PCI in Blida), and safety of an immediate return after PCI to our center. Hundred and seventy-nine patients were included, 66% were men, mean age was 65.1 years, hypertension appeared to be the predominant CV risk factor, present in 58% of patients. STEMI accounted for 48.6% of admissions, of which 61% received within the revascularization time-frame, time from symptoms onset to fibrinolysis was 217.5 min (15–600 min) with a success rate of 79.2%, PCI was performed in 52.4% of patients with an average delay of 20.5 h (5 h to 33 h), rescue PCI could be achieved in an average time of 15.5 h (4 h to 21 h) in 54.5% of patients with fibrinolysis failure. For NSTEMI patients, 52.2% were at high risk, 81.2% of whom were tranferred to PCI within an average time of 61 h (16–94 h). We recorded 9.8% of very high-risk patients, and 18.5% intermediate risk, all transferred to PCI in an average delay of 28.5 h (15–41 h) and 56 h (6–96 h) respectively. No incidents or accidents were noted during transfer to cath-lab. Mean hospital stay was 5.2 days and the overall CV mortality was estimated at 4.1%. Providing acceptable revascularization delays in rural areas was a “challenge” that we noted with encouraging results. We will focus our efforts on education and medical training in order to improve access to care for a population living in landlocked areas that had previously been completely deprived.