Background: This study assessed the effects of combination therapy of simvastatin and carvedilol on clinical outcome in patients with left ventricular (LV) dysfunction after acute myocardial infarction (AMI). Methods: We retrospectively studied 672 patients with LV dysfunction [LV ejection fraction (LVEF) < 40%] complicated with AMI who underwent percutaneous coronary intervention (PCI). The patients were divided into four groups: combination group (n=160), simvastatin only group (n=216), carvedilol only group (n=242), neither treatment group (n=54). Results: At 6-month after PCI, the LVEF was improved most significantly in combination group. During 1-year follow-up, cardiac death occurred most frequently in neither treatment group compared with another three groups (combination: 4%, simvastatin alone: 7%, carvedilol alone: 8%, neither: 17%, p<0.001 between neither treatment and another three groups). The results on major adverse cardiovascular events (MACE) showed that the combination of simvastatin and carvedilol was associated with a relative risk reduction of 53% (p<0.001), treatment with simvastatin alone with a relative risk reduction of 44% (p=0.001), and carvedilol alone with a relative risk reduction of 40% (p=0.003) compared with neither treatment. The independent predictors of 1-year MACE were neither treatment, elevated high sensitivity C-reactive protein (��� 0.5 mg/dl), and old age (> 70 years). Conclusion: Combination therapy with simvastatin and carvedilol had a positive impact on the end points of cardiovascular death and MACE and seems to have additive beneficial effect on these end points in patients with LV dysfunction complicated with AMI who underwent PCI.