Background:Cardiovascular disease is the main reason for mortality in men and women. Clinical epidemiology of myocardial infarction (MI) in men and women has not been yet studied in Iran, one of the largest Middle East countries in South-Western Asia. This study was conducted to determine the clinical epidemiology of MI in men and women in Iran.Methods:This hospital-based, cross-sectional study used the data of 20,750 MI patients in Iran in 2012 (the codes I22, I21, I24, and I25.2). Univariate comparisons used Chi-square test for categorical variables and t-test for continuous variables. P < 0.05 was considered as significant.Results:Totally, 20,750 MI patients (15,033 men and 5,717 women) with age range of 13–106 (mean; 61.2 ± 13.4) years were enrolled. Only 9 (0.04%) patients (8 men and 1 woman) were ≤18 years (mean age: 14.8 ± 1.9), out of whom only two men were diabetic. 22.2% (18% men and 33.4% women) of the patients had diabetes, 26.2% (28.5% men and 20.1% women) were smoker and 35.5% (28.6% men and 53.7% women) had hypertension. ST-segment elevation MI incidence was 2.8 times higher in men than women. Left bundle branch block was significantly more prevalent in men than women. Men used percutaneous coronary intervention more frequently than women did. No difference in coronary artery bypass graft was noted between men and women. Mortality incidence was approximately twice higher in men than women. The prevalence of chest pain was higher in women than men.Conclusions:The MI incidence pattern, mortality from MI, and risk factors prevalence are significantly different between men and women in Iran. More emphasis on these issues in training people and healthcare professionals seems to contribute partially to patients’ timely referring to health care centers and preventing MI-associated mortalities.