Effective, early and rapid reperfusion therapy is the most important goal in the treatment of patients with acute ST-segment elevation myocardial infarction (STEMI). Timely performed primary percutaneous coronary intervention (pPCI) is undoubtedly the strategy of choice in the treatment of STEMI and in the last decade pPCI has replaced fibrinolytic therapy as a way revascularization strategy. Many clinical studies have shown that patients treated with fibrinolysis should be routinely moved to the invasive cardiology center for elective percutaneous coronary intervention (PCI) within 24 hours and that this early invasive strategy leads to a stabilization of the target lesion and lowers the incidence of recurrent ischemia. The latest European Society of Cardiology Guidelines for the management of patients with STEMI award the Class I indication to the pharmacoinvasive strategy. This review article presents the most important clinical research on pharmacoinvasive strategy and importance of this method of treatment of STEMI. This method of reperfusion leads to a significant reduction in reinfarction and recurrent ischemia without increased risk of bleeding and implementing this strategy in regional protocols for the management of patients with STEMI would increase the number of patients who are to receive proper and timely reperfusion therapy.