Myocardial infarction (MI) is a major cause of morbidity and mortality in developed countries. However, significant advances have been made over the past 25 years decreasing its in-hospital and long term death rate and complications. The routine use of thrombolysis, aspirin, and beta blockers has led to significant improvement in the prognosis of patients with MI's. Most recently, attention has focused on interventions designed to attenuate or halt the progressive left ventricular (LV) enlargement which may frequently develop following infarction. This article examines the pathophysiology of ventricular remodeling and strategies thought to limit its morbid implications.