Objects: There was limited data about impact of gender in clinical outcome after percutaneous coronary intervention (PCI) after acute myocardial infarct. We analyzed the effect of sex on clinical characteristics and major adverse cardiac event (MACE) that composed with any cause of death, myocardial infarct, target vessel revascularization and target lesion revascularization. Methods: Total 820 patients who underwent PCI due to acute myocardial infarct were analyzed from May 2003 to Jul. 2008 in our hospital. Results: Of the 820 patients, 290 (35.4%) were women. Women were significantly older than men (67.9 짹 10.4 vs 58.6 짹 11.5, p < 0.01). Hypertension (61.2% vs 45.8%, p < 0.01), diabetes (42.8% vs 27.4%, p < 0.01) and never-smokers (26.6% vs 75.1%, p < 0.01) were more common in women. There were no difference in history (Hx) of prior myocardial infarct, previous PCI and cerebrovascalar attack (CVA). There were no difference in medications except ACE inhibitors (53.4% vs 60.8%, p = 0.046). There were no difference in incidence of ST-elevation myocardial infarct (71.3% vs 65.2%, p = 0.07) but Killip class II and III were more common in women (Killip I: 77.5% vs 82.9%; II: 6.6% vs 3.8%; III: 4.8% vs 1.9%; IV: 11.1% vs 11.4%; p = 0.03). Mean ejection fraction and extent of coronary disease (1-, 2-, or 3-vessel disease) showed no difference. At 1 year clinical follow-up period, women showed lower incidence of composite MACE in women (7.9% vs 13.0%, p = 0.03). Logistic regression analysis revealed that age, killip class and Hx of CVA were independent predictors of MACE for men and only Hx of diabetes for women (age: odd ratio (OR) = 1.05, 95% confidence interval (CI) = 1.012~1.079, p < 0.01; killip class: OR = 4.82, 95% CI = 1.389~16.694, p = 0.013; Hx of CVA: OR = 4.25, 95% CI = 1.557~11.585, p < 0.01; Hx of diabetes: OR = 3.44, 95%CI = 1.280~9.218, p = 0.014). Conclusion: Although women with acute myocardial infarct had high-risk characteristics, women showed lower incidence of MACE after 1 year from PCI. Age, killip class and Hx of CVA were independent predictors of MACE for men and only Hx of diabetes for women.