Coronary heart disease is a major cause of death worldwide. There were many therapeutic interventions developed over the past two decades but not all are successful. Streptokinase is one of the earliest and widely used drug proven in clinical trials to be useful in the lysis of blood clots within the coronary vessels during acute myocardial infarction. However it was later found out that success is not always guaranteed. The current study aimed to determine the failure rate of using streptokinase in acute myocardial infarction and to assess for factors associated with its failure. This book also provides an in-depth review on this subject.