Among1297 patients with STEMI admitted to the coronary care unit and subjected to PCIs from 2006 to 2015 there were 330 women(25.4 %). Data from 161 women (48.8 %) who underwent DS were compared with those from 169 women who underwent indirectstenting (IS). Among patients of IS group in 148 (87.6 %) stenting was performed after predilation, in 7 (4.1 %) after manual thrombusaspiration, and in 14 (8.3 %) after combination of predilation and thrombus aspiration. The rate of angiographic success washigher in the DS group (97.5 vs. 87.6 %, р<0.001). Rates of deaths (4.3 vs. 11.8 %; p=0.013), major adverse cardiac events (MACE)(4.3 vs. 13 %; p=0.005), and no-reflow (1.9 % vs. 11.2 %; p=0.013) were significantly lower in the DS group. There were no differencesin rates of recurrent myocardial infarction and access site complications. Following propensity score matching, each group contained 78 patients. Rates of MACE (2.6 vs. 14.1 %; p=0.009) and deaths (2.6 vs. 12.8 %; p=0.016) remained significantly lower in the DS group. After multivariate adjustment, DS strategy was independently associated with lower mortality (odds ratio [OR] 0.29; 95 % confidence interval [CI] 0.09-0.97; p=0.04) and MACE (OR=0.28; 95 %CI 0.09-0.087; p=0.03). DS strategy in STEMI female patients turned out to be safe and effective technique.