The purpose of this review is the evaluation of the available data related to thrombolytic therapy. The pharmacological and clinical characteristics of thrombolytic agents of the first, second and third generations are discussed. The results of the cooperative studies dealing with thrombolysis using streptokinase, tissue plasminogen activator, urokinase and prourokinase are reviewed. Short-term mortality has decreased about 50% in patients with acute myocardial infarction with thrombolytic treatment. The main factors which influence outcome are: the time interval between onset of symptoms and beginning of the treatment, the extent of restoration of myocardial function, the degree of residual stenosis and concomittant medication. During the follow-up after thrombolysis the benefit of aspirin was shown, the question of immediate coronary angioplasty is unresolved. The important risk of thrombolytic treatment is intracerebral bleeding, which appears up to 2% of patients treated with streptokinose and tissue plasminogen activator.