Objectives: We sought to assess the effect of early statin therapy in patients with cardiogenic shock (CS) complicating acute myocardial infarction (MI). Background: The benefit of early statin treatment following acute MI complicated with CS has not been well studied. Results: We studied 533 statin-naïve patients with acute MI and CS (Killip class IV) who underwent revascularization therapy between November 2005 and January 2008 at 51 hospitals in the Korea Acute Myocardial Infarction Registry. Patients were divided into 2 groups: those who received statins during hospitalization (n=280) and those who did not (n=273). Influence of statin treatment on 12-month clinical outcome was examined using a matched-pairs analysis (n=200 in each group) based on propensity for receiving statin therapy during hospitalization. Before adjustment, patients receiving statin, compared to those not receiving statin, had more favorable clinical profile, were less likely to suffer procedural complications, and more likely to receive adequate medical therapy. Patients receiving statin had lower unadjusted in-hospital mortality and composite rate of mortality, MI, and repeat revascularization at 12 months, which remained significantly lower after adjustment for patient risk, procedural characteristics, and treatment propensity. Conclusions: In CS patients with acute MI undergoing revascularization therapy, early statin treatment initiated during hospitalization was associated with lower rates of in-hospital death and 12-month adverse cardiac events.