Acute myocardial infarction (AMI) as an acute form and a catastrophic manifestation of coronary artery disease (CAD) is the major cause of morbidity and mortality worldwide. The prevalence and incidence of myocardial infarction can be influenced by demographic, biological and psychosocial factors, and it is rare in childhood and adolescent years. Contrary to the elderly, where cardiac attack is mainly caused by CAD, exercise-induced cardiac attack is relatively more prevalent in a young adult. We report here on a case of ST-segment elevation myocardial infarction (STEMI) in a young adult during vigorous physical activity and we review the relevant literatures.