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The objectiveof the study was to reveal the features of development and clinical course of acute arterial embolism (AAE) of aorta and main limb arteries in patients with myocardium infarction (MI).Material and methods. Since 1991 until 2018 in the department of cardiovascular surgery of «North-Western State Medical University named after I. I. Mechnikov» 1782 patients with AAE of aorta and main limb arteries were urgently treated. 102 (5.7 %) patients of them waswith acute IM.Results.In patients with AAE in acute phase of Q-IM the embolism to large profile arteries was typical. AAE led to rapid progression of limb ischemia. The severity of the general condition of patients due to myocardial lesions, and specific complications associated with limb revascularization and ischemic syndrome, significantly influenced the results of treatment. Postoperative mortality reached 38.8 %.Conclusion.AAE of aorta and main limb arteries is a threatening complication of acute MI, and it significantly worsens prognosis.