OBJECTIVES:  Acute myocardial infarction (AMI) is a global health problem. Little is known as to the cost burden of the disease to the Alberta health care system. We sought to examine the health care costs associated with AMI in Alberta, Canada between 2004- 2013. METHODS: We linked six Albertan health databases, including ambulatory care, discharge abstract database, practitioner claims, pharmacy information network, population registry, and vital statistics to identify patients with a primary diagnosis of AMI (ICD-10 codes I21 or I22) during 2004- 2013. We used Alberta Health Data Application to provide unit cost for ambulatory care and inpatient services and Alberta Drug Benefit List to provide unit drug price. AMI health care costs were grouped in to ambulatory care, inpatient, practitioner claims and drug costs. All costs were inflated to 2016 Canadian dollar values. RESULTS:  52,912 patients (55,384 hospitalizations; 75,309 ambulatory care visits; 497,716 practitioner claims; and 4,003,982 drug dispensing events) with AMI were included in the analysis. Females accounted for 32.7% of study population. Patient age (median (IQR)) decreased during the study period (2004: 68 (56-79); 2013: 65 (56-77); p<0.001). Total hospitalization, ambulatory care, practitioner claims, and drug costs were $760.5 million (2004: $80.4 million; 2013: $70.7 million), $91.5 million (2004: $9.6 million; 2013: $6.4 million), $71.4 million (2004: $5.6 million; 2013: $8.8 million), and $118 million (2008: $19.1 million; 2013: $17.7 million), respectively. Cost per hospitalization and ambulatory care visit decreased from $16,191 and $1,282 in 2004 to $11,544 and $1,191 in 2013 (p<0.001), respectively. CONCLUSIONS: Health care costs for AMI in Alberta are significant; however, they decreased during the study period, except for practitioner claims costs. Not surprisingly, hospital services accounted for the most of the AMI care costs. Strategy to shift AMI management to outpatient settings is needed to alleviate the AMI care cost burden.