Background and Objectives: Speed of reperfusion is critical in ST-segment myocardial infarction (STEMI), and it makes a difference to the results and prognosis. This study was designed to investigate the hospital visit patterns and it���s effect on the therapy and prognosis of STEMI patients. Methods: The study was carried out between December 2006 and July 2007 in 3 University Hospitals. Total 113 patients who visited with STEMI were enrolled. All patients were divided into two groups; Group 1 (n=38) who directly visited to hospitals with primary angioplasty facilities, Group 2 (n=75) who first visited local hospitals and then transferred to angioplasty-capable hospitals. Chest pain (CP)-to-door time gap, the time difference between actual CP-to-door time and estimated CP-to-door time measured by Navigator, were measured. We analyzed pre-hospital delay, reperfusion time, CP-to-door time gap, medication at local hospitals and in-hospital outcomes. Results: There was no difference of prehospital time delay between group 1 and group 2. Thirty-one patients (78.9%) in group 1 and 68 patients (78.7%) in group 2 underwent reperfusion therapy at primary or secondary hospitals. CP-to-door time (169.7짹126.0 vs 345.4짹396.8 min, p=0.023) and CP-to-reperfusion time (249.3짹150.1 vs 476.6짹430.0 min, p=0.007) were shorter in group 1. Time gap was also shorter in group 1 (150.4짹122.7 vs 304.8짹392.2 min, p= 0.042). Group 2 patients were received nitrate (49%), aspirin (32%), and thrombolytic therapy (5.3%) at primary hospitals. In-hospital mortality was higher in group 2 (0 vs 5 %, p=0.045). Conclusion: A lower percentage of STEMI patients received reperfusion therapy at primary local hospitals. Primary visit to non-PCI hospitals was associated with substantially longer times to reperfuson therapy and it was associated with higher mortality.