Data on ST elevation myocardial infarction in patients aged over 75 years remains sporadic. The prognosis for ST Segment Elevation Myocardial Infarction (STEMI) patients is bleak. Mortality at one year in patients aged over 80 years is very high. We describe a series of elderly patients over 75 years treated by emergency physicians in pre-admissions or in emergency wards presenting with acute ST elevation myocardial infarction, and we compare these data with a second group of patients aged below 75 years.