Before the primary percutaneous coronary intervention program was implemented, few acute myocardial infarction patients were treated using the technique, even though less than 40%were reperfused using thrombolytic agents. In 1988, we started to use primary percutaneous coronary intervention to treat all patients admitted with acute myocardial infarction to the Virgen de la Arrixaca University Hospital in Murcia, Spain. In 2000, we developed a program, APRIMUR, to treat acute myocardial infarction using primary percutaneous coronary intervention throughout the Murcia region. The first phase involved only three hospitals in the regional capital. The program was then extended to the rest of the region in 2001. This article describes the first phases of the program, including patient transport and work methodology, the primary and secondary aims of the program, what we regard as the program's key features, and the sustainability of the program. More than 3500 primary percutaneous coronary interventions have now been performed, at a mean rate of 40-45 per month. Annual mortality ranged from more than 10%at the beginning of the program to, more recently, 6.0%in 2007 and 6.6%in 2009. We have achieved a reperfusion rate greater than 90%in at least half the region and the rate is increasing each year in the remaining districts.