Older people are more at risk of acute myocardial infarction, and suffer a higher morbidity and mortality. With a rapidly ageing population, there will be an increasing number of elderly patients presenting with acute myocardial infarction. In the past, the elderly have been undertreated, partly due to an erroneous impression that they cannot tolerate active treatment. However, evidence is accumulating that the older age group can derive significant benefit from thrombolysis, cardiological interventions, secondary prevention, and rehabilitation. This article reviews the latest literature on the various treatments available for acute myocardial infarction, concentrating on the proven benefits for the older age group.