Abstract Background: Accurate diagnosis, characterization, and quantification of myocardial infarction (MI) are essential to assess the impact of therapy and to aid in predicting prognosis of patients with ischaemic heart disease. Objective: This study aimed to define different parameters regarding prediction of myocardial functional recovery following successful reperfusion of acute ST segment elevation myocardial infarction (STEMI). Patients and methods: This prospective study was carried out in Zagazig University and National Heart Institute (NHI) of Egypt during the period from June 2020 to June 2021. The study included 48 patients admitted with first acute STEMI. All patients were subjected to demographic data taking, electrocardiography and echocardiography examination (two examinations were done, the first was immediately after reperfusion and the second was 3 months from primarypercutaneous coronary intervention (PCI). Results: There was no statistically significant difference between demographic data and risk factors except smoking habit. Regarding laboratory findings there were significant lower troponin value, peak CKMB value compared to patients had remolding (p=0.0001, p=0.027 respectively). Regarding ECG parameters, there was no statistical significant difference between the study groups regarding sum ST elevation and MI territory (p value > 0.05), but there was highly statistically significant difference between the study groups regarding 90 min ST resolution among contractile recovery (group I) p=0.0001. Conclusions: In this study patients affected by AMI with ST segment elevation and treated by primary PCI showed contractile recovery in 60.4% of the patients, while the remodeling of the LV has been observed in 39.6%.