Objectives: After acute myocardial infarction (AMI), evidence-based medication including aspirin, beta-blockers (BBs) and angiotensin-converting enzyme inhibitors (ACEIs) and statins is recognized as crucial to reduce risk of a subsequent cardiovascular events. However, the use of evidence-based medications recommended by current guideline after AMI is not well known at real-world practices in Korea. We examined the use of evidence-based medications at in-hospital and discharge after AMI, and its correlation with in-hospital mortality and 1-month MACE. Methods: We evaluated 2247 patients hospitalized with AMI (age:64.3짹12.7, M:F=1606:641, STEMI:NSTEMI=42.6:57.4 %) from the multi-center registry of AMI (Korean Working Group of Myocardial Infarction). The primary outcome was the use of aspirin, BBs, ACEIs, and statins in patients at in-hospital and discharge. Correlations between medication use and in-hospital mortality or 1-month MACE were assessed. Results: In the registry, initial Killip class, systolic BP, maximal CK were as follows 1.5짹0.9, 129.8짹39.9 mmHg, and 1328짹3226 IU/L. In 93.7% of STEMI patients, adequate reperfusion therapy was preformed (primary PCI:thrombolysis=84.7:5.5 %, facilitated PCI=3.5 %). In PCI cases including NSTEMI, the achieved rate of more than post-PCI TIMI flow 2 was 96.6 %. In-hospital mortality rate was 5.3 %. Among 814 eligible patients, 2.5% has 1-month MACE. The use rates of aspirin, BBs, ACEIs and statins at in-hospital were as follows 98.5, 75.1, 70.8 and 70.1 %. At discharge, those were as follows 97.4, 76.3, 68.0 and 73.8 %. The rates of medication prescription were similar at hospital discharge and 1 month follow-up. Asprin, BBs, ACEIs and statins showed relatively weak correlation with in-hospital mortality (r=0.21, 0.19, 0.21, 0.15, 0.06, p<0.001), but not 1-month MACE. Conclusion: Higher rates of evidence-based medication use after AMI were carried out at the real-word practice. Although further studies should assess the causal relationship and longterm follow up, these findings suggest that the adequate medication recommended by current guideline may be one of the possible explanations for low mortality rate of AMI patients in Korea.