Purpose: Delayed enhancement MRI detects myocardial infarction by visualizing contrast media accumulation in infarcted segment. T2-weighted MRI has a potential to differentiate infarct-related myocardial edema as a marker of acute myocardial injury and fibrosis as that of chronic myocardial injury. We investigated the clinical utility of an approach combining both techniques to differentiate acute from chronic myocardial infarction. Materials and Methods: One hundred fifteen patients underwent cardiovascular MR image for assessment of myocardial viability from July 2003 to July 2004. We retrospectively reviewed 30 patients MR images who underwent both T2-weighted image and delayed enhancement. We assessed the T2-signal intensity (low, iso, high) for the corresponding areas of delayed enhancement. Also, we compared the extent of low or high signal intensity area in T2-weighted imaging with delayed enhancement. We assessed an age of myocardial infarction based on clinical information and correlated with T2 signal intensity. Results: Of 81 segments, 28 patients exhibited delayed enhancement. In T2-weighted MR images, 42 segments of 15 patients showed higher signal to noise ratio than the normal myocardium (175짹9%, p < 0.05) and 34 segments of 11 patients showed lower signal to noise (73짹5%, p < 0.05). Three patients had both high and low signal intensity area in T2-weighted MR images, suggesting have acute and chronic myocardial infarction. The extent of T2 high signal intensity area was larger than the area of delayed enhancement but T2 low signal intensity area was same with the area of delayed enhancement. T2 high signal intensity was detected within 11days from clinical evidence of myocardial infarction but T2 low signal intensity was detected after 7months. Conclusion: An imaging approach combining delayed enhancement and T2-weighted MRI accurately differentiates acute from chronic myocardial infarction.