Secondary prevention following acute myocardial infarction begins at the time of the in initial hospitalization. An aggressive approach should focus on appropriate lifestyle changes as well as pharmacotherapy. Smoking cessation, increased physical activity and lipid lowering are key lifestyle objectives, while beta blockade and aspirin should be routinely prescribed for all patients following acute myocardial infarction, unless there are specific contraindications. Improvement in survivorship, prevention of nonfatal reinfarction, regression of atheromatous disease as well as a better quality of life are all proven benefits of secondary prevention.