Acute myocardial infarction has been regarded as one of the rarest cardiovascular diseases in the African continent. Recent findings have shown that the incidence is on the increase. To provide more information on the burden of this deadly disease in Nigeria and in the West African sub –region. This study is a 10 - year retrospective study of the frequency and presentation of acute myocardial infarction in the University of Benin Teaching Hospital (UBTH), in Benin City, Nigeria, from January 1998 to December 2007. Twenty-six patients with acute myocardial infarction were admitted into the UBTH within the period of study giving a frequency of 0.4/10,000 hospital population. The average number of patients presenting with this condition increased over the years. The most common risk factors among them were hypertension, hyperlipidemia, age, social class, obesity, high BMI, reduced physical exercise and significant alcohol intake, in order of decreasing frequency. Extreme weakness, sweating, left ventricular failure and severe chest pain were the commonest clinical features in order of decreasing frequency. Q-wave infarct was present in 10(38.5%) cases. Myocardial infarction will not continue to be rare in Nigeria and in Africa.