This study investigated whether ischaemic postconditioning can improve recovery of myocardial contractile function in acute myocardial infarction patients 1 week and 6 months after angioplasty. A total of 62 patients undergoing direct percutaneous coronary intervention after acute myocardial infarction were randomly assigned to receive four episodes of inflation and deflation of the angioplasty balloon in the early reperfusion period (postconditioned group, n = 32), or no additional intervention (control group, n = 30). Two-dimensional size and left ventricular (LV) global and regional contractile functions were then evaluated by echocardiography at 1 week and 6 months after angioplasty. At 1 week, there were no significant differences in left atrial diameter, LV enddiastolic diameter, LV end-diastolic volume, cardiac output, LV ejection fraction or wall motion score index between the two groups. At 6 months, LV ejection fraction was significantly increased and the wall motion score index significantly reduced in the postconditioned group compared with the control group. Ischaemic postconditioning can improve long-term LV contractile function 6 months after reperfusion following acute myocardial infarction.