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Objective: To assess the association of the A1166C polymorphism of the angiotensin II type-1 receptor (AT1R) gene with acute myocardial infarction and also with the severity of coronary artery disease., Methods: A prospective, cross-sectional study was carried out with 110 patients with acute myocardial infarction, who, on coronary angiography, had significant lesions (> 50%) assessed according to 3 criteria of severity: number of vessels affected, morphology of the atherosclerotic plaque, and coronary risk score. The control group comprised 104 individuals with no coronary lesions. The A1166C polymorphism of AT1R gene was determined by polymerase chain reaction in the DNA of leukocytes in peripheral blood. The classic coronary risk factors were analyzed in all individuals., Results: When stratifying the genotypes in regard to risk factors, only smoking predominated in the AC heterozygous patients (P = 0.02). The genotypic frequency in the infarcted patients was as follows: AA = 54.5%; AC = 35.5%; and CC = 10%, which was similar and nonsignificant in regard to that in the control group (P = 0.83). No risk increase occurred for acute myocardial infarction when comparing the genotypes as follows: CC vs AA (OR = 1.35; 95% CI = 0.50 - 3.59); AC vs AA (OR = 1.03; 95% CI = 0.58 - 1.84); and AA+AC vs AA (OR = 1.33; 95% CI = 0.51 - 3.45). None of the severity criteria showed a significant correlation with the genotypes., Conclusion: According to our results, no correlation exists between the A1166C polymorphism of the angiotensin II type-1 receptor (AT1R) gene and acute myocardial infarction or the severity of coronary artery disease.