As predicted, coronary artery disease is being recognized with increasing frequency in the town hospitals in Papua New Guinea. This report contains the clinical characteristics of 20 patients with acute myocardial infarction admitted to the Port Moresby General Hospital. The clinical features of acute myocardial infarction were typical of the disease anywhere. The seemingly rare frequency of angina of effort in this group of patients is an interesting observation. The high in-hospital case fatality rate observed here is alarming. Urban dwelling, the male gender, smoking and diabetes were important risk factors in the development of this disease in these patients.