Smoking is a well-known risk factor for coronary artery disease, and is associated with increased rates of myocardial infarction and cardiovascular death. However, there are some data showing lower mortality of smokers comparing to non-smokers in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study is to evaluate the influence of smoking on outcome and mortality in patients admitted for STEMI. This study included a total of 98 patients. They were divided according to smoking status during STEMI presentation into those who were current smokers (47 patients, 36%) and non-smokers (51 patients, 64%). Hypertension (p=0,005), diabetes (p=0,013), dyslipidemia (p=0,021), history of myocardial infarction (p=0,042) and coronary angioplasty (p<0.05) were significantly associated with cigarettes smoking. In admission of patients, 87% of all STEMI smoking patients are treated with thrombolysis versus 37% in non-smoking group (p<0.05). Mean Ejection fraction was 47% in group non-smokers versus 43% in the other group. Rhythmic complications were significantly more in non-smoking groups. Biological markers of myocardial infarction (AST, CPK, LDH and troponin IC) were significantly higher in the smokers. The coronary-angiography showed more single vessel coronary disease in smoking patients (p=0,015) versus more double and triple vessel disease in non-smoking group (p=0,037). The one-year mortality was significantly higher in the smokers (12.8%) versus 6% in the non-smoking group (p=0.003). Current smokers with STEMI have higher mortality at 1 year comparing to non-smokers, these results emphasize the role of efforts to encourage smoking cessation as prevention of myocardial infarction. The author hereby declares no conflict of interest