Background and Objectives: We have developed a new porcine model of acute myocardial infarction (AMI) and ischemic heart failure and pathologic findings of coronary artery by transcatheter intracoronary ethyl alcohol injection. Subjects and Methods: Twelve female pigs underwent transcatheter injection in the left anterior descending artery (LAD) using alcohol to produce apicoanteriorseptal AMI. Low pressure ballooning using 2.5 mm over-the-wire balloon just above the second diagonal branch for eight pigs and the first diagonal branch for four pigs was followed by injection of 1 ml 99.9% ethyl alcohol. Follow-up coronary and left ventricular (LV) angiograms and echocardiography were performed at 4 weeks after alcohol injection. Myocardial SPECT using 201Tl (and 99mTc-MIBI) and triphenyl tetrazolium chloride (TTC) stain were performed after sacrifice. The quantity of TTC stain and amount of 201Thallium uptake were compared by the Vision Workstation. The histopathologic findings of Infarcted myocardium and coronary artery was demonstrated after 28 days. Results: The procedure-related mortality was observed in two-pigs of proximal LAD injection. Four pigs suffered from ventricular tachycardia, which was converted into sinus rhythm by dc cardioversion. Four-week follow-up coronary angiography revealed occluded LAD in all pigs persistently. LV angiogram showed akinetic movement in apicoanteroseptal wall with ejection fraction of 46.5짹3.3%. Myocardial SPECT revealed perfusion defect in the apicoanterior wall of all pigs. The percent area of perfusion defect was 22.2짹3.06%. TTC stain did not stain the myocardium in apicoanterior wall. The percentage of non-stained myocardium was 23.5짹2.70%. Histologic examination revealed severe fibrosis in the infarcted myocardium and massive thrombus with organization and calcification. Conclusion: The porcine model of acute myocardial infarction by intracoronary ethanol injection in the distal LAD is safe, reliable and reproducible, can be used for the future researches of myocardial regeneration and ischemic LV failure.