Since the prognosis of myocardial infarction with ST elevation (STEMI) depends on its immediate handling and on secondary prevention measures, not following the recommendations could impede the improvement of the population affected by this disease. The aim was to describe the clinical-epidemiologic profile and the process of care of patients with STEMI in a tertiary hospital.We analyzed the clinical information, the risk stratification, the revascularization therapy and the prescription trends at discharge of patients with STEMI attended in one year.246 patients with a mean age of 61 years were included; 76 % were men. Most of the cases of STEMI (37.3 %) were patients from 60 to 69 years. The most prevalent risk factor was sedentarism. The TIMI score was low in 81.7 % of the cases. Residual ischemia/viability was detected in 35 %, and coronary obstructions were found in all the cases of catheterized patients. Percutaneous coronary intervention was carried out in 76 %, mainly with drug-eluting stents (77.5 %). At discharge, statins and antiplatelet agents were prescribed in more than 90 %; other drugs were prescribed to 64-82 % of the cases.STEMI predominates in sedentary men over 60 years. Using stents to stratify risk, to look for residual ischemia/viability, and to revascularize with drug-eluting are common practices, but the compliance of evidence-based guidelines, although better than in the past, is not optimal yet.