Acute myocardial infarction (AMI) involving two simultaneous vascular territories of acute transmural ischemia is known as a double or combined myocardial infarction. This well described but extremely rare phenomenon may be related to the fact that AMI with multiple vessel obstruction often causes extensive myocardial injury and death before hospitalization. We reported the first case of 45-year-old man with AMI occluded left anterior descending artery and right coronary artery simultaneously in Korea.