BACKGROUND Myocardial infarction is a major emergency involving life-threatening in the absence of appropriate treatment. The aim of this study was to analyze the problem of management of myocardial infarction in a second reference hospital in Mali. METHODS This was a prospective descriptive study over a period of six months from January to June 2010. It concerned all patients admitted for myocardial infarction in intensive care.The diagnosis was suspected in chest pain or the occurrence of complications (PAO, cardiogenic shock) and electrocardiogram signs on at least two precordial leads. The parameters studied were: age,reason for admission, risk factors, hemodynamic parameters, the deadline for completion of the ECG, the topography of lesions and electrical changes within 15 days. RESULTS A male was found with a mean age of 54.62 years. Chest pain was the main reason for admission (6 cases) followed by cardiogenic shock (1 case) and acute pulmonary edema (1 case). The electrocardiogram was performed in 7 patients more than 24 hours after admission. The anterior territory was the most affected. On admission three patients had a systolic pressure below 90 mmHg.The evolution was marked by occurred heart failure (3 cases) and death (2 cases). CONCLUSIONS The lack of diagnostic and therapeutic method in our heath facility helps to increase morbidity and mortality associated with myocardial infarction.