Abstract: AIM: The effectiveness of direct percutaneous coronary intervention (PCI) for young adults (<35 years) and their clinical characteristics and estimated outcome has been limited. In this report we retrospectively evaluated the effectiveness of direct PCI for very young adults with acute myocardial infarction (AMI) and estimated their clinical characteristics and outcome. METHODS: Of the 530 patients with AMI, five were 35 years old or younger (0.9%) and were studied during a 1-year period (2007-2008). The usefulness of PCI in these five consecutive patients with a first AMI was assessed. RESULTS: Five AMI patients ranging in age from 26 to 35 years underwent direct PCI for the culprit lesions. The lesions targeted for PCI were located in the left anterior descending artery and left circumflex artery in three patients and in the right coronary artery in two patients. In all patients, PCI was angiographically effective at the acute phase without complication. Six-month postoperative follow-up revealed no major adverse cardiac event. CONCLUSION: Direct PCI for young adults with AMI is safe and effective.