Background: Acute myocardial infarction (AMI) is a major cause of heart failure. However, the factors that may influence non-recovery of left ventricular function (LVF) after an AMI are still unclear. The aim of this study was to identify variables that may influence non-recovery of LVF in AMI patients who underwent percutaneous coronary intervention (PCI). Methods: A total of 108 patients with AMI with systolic dysfunction [ejection fraction (EF) < 45%] underwent PCI were included. LVF recovery was defined as improvement of LVEF more than 10% compared to baseline LVEF or LVEF > 55% at follow-up. We divided them into two groups: Group I (LVF recovery, n=77) and Group II (no LVF recovery, n=31). We compared clinical findings and major adverse cardiovascular events during 12-month follow-up. Results: Follow-up EF was 60짹7 % in Group I and 43짹7 % in Group II. More patients had anterior wall MI (57.1% vs. 74.2%, p=0.045) and history of previous PCI (6.5% vs. 22.6%, p=0.016) in Group II. Cardiogenic shock was observed more frequently in Group II (7.8 % vs. 22.6 %, p=0.033). The baseline C-reactive protein, monocyte count, and LDL-C were significantly higher in Group II (2.0짹2.1 vs. 3.4짹3.8 mg/dl, p=0.017, 731짹332 vs. 1090짹1166/mm3, p=0.025, 129짹19 vs. 141짹30 mg/dl, p=0.021, respectively). ACE inhibitors, beta blockers, and statins were less frequently used in Group II (70.1% vs. 48.4%, p=0.036 and 81.8% vs. 67.7%, p=0.024, and 61.3% vs. 41.9%, p=0.045). Follow-up CRP level was higher in Group II (0.8짹1.2 vs. 1.7짹1.2 mg/dl, p=0.039). There were no significant differences in the incidence of cardiac death, cerebrovascular accident, and target vessel revascularization between both groups. However, reinfarction was observed more frequently in group II (0% vs. 9.7%, p=0.006) at 12-month clinical follow-up. Conclusion: AMI patients who had not shown LVF recovery had more anterior wall MI and cardiogenic shock, and were associated with higher levels of inflammatory markers and less frequently used ACE inhibitors, beta blockers, and statins. Our findings emphasize intensive medical therapy as well as early intervention is needed for LVF recovery in patients with AMI with LV dysfunction.