The recent literature concerned with postoperative myocardial infarction is limited to relatively few detailed reports.1-3 Advances in surgical and anesthetic procedures and the improvement in the pre- and postoperative care of the patient entail revision of the data of the older literature. Myocardial infarction is not an uncommon postoperative complication; it is particularly prevalent in the older age group. Recent data (1954, 1956)4,5 suggest that myocardial infarction is responsible for 10% of the deaths following major operations in patients above the age of 60 years. The incidence may be even greater, since necropsies indicate that the clinical diagnosis of myocardial infarction as the cause of sudden death is missed in about 50% of the cases.5 The purpose of this study is to present three years' experience (1954-1957) at the Graduate Hospital of the University of Pennsylvania with postoperative myocardial infarction and to discuss the predisposing and precipitating factors, clinical findings,