Background: Acute myocardial infarction is the first cause of death among adults in Chile. It caused 5,650 deaths during 2001. Aim: To analyze the evolution and mortality of Acute Myocardial Infarction in Chile between 1990 and 2001. Material and methods: Analysis of data on mortality caused by Acute Myocardial Infarction in Chile, obtained from the databases of the Ministry of Health. The adjusted mortality rates and disability adjusted life years (DALY) were calculated for the period. Results: In the study period, adjusted mortality decreased from 86 to 67.6 deaths/100,000 inhabitants. The DALYs ratio between men and women increased from 2.7 to 2.9. The mean death age for men and women was 69.9 and 76.5 years respectively (p <0.001). Forty five percent of women and 51% of men died at home, 78% of women and 66% of men received medical attention. Conclusions: Although there was a reduction in mortality caused by acute myocardial infarction in the study period, there are still gender differences in the age of death, and access to medical care (Rev Méd Chile 2004; 132: 1227-33)