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Objectives: In this study, we aimed to determine whether body mass index (BMI) is an independent predictor of in-hospital mortality in ST-segment elevation myocardial infarction (STEMI) patients and to assess the relationship between BMI and mortality. Methods: One thousand three hundred fifty-seven patients with STEMI were included to the study. Primary outcome was in-hospital mortality. The multivariable logistic regression was used to assess the relationship between BMI and in-hospital mortality using age, gender, diabetes mellitus, systolic blood pressure, heart rate, smoking status, serum creatinine and hemoglobin, type of STEMI, and Killip class as adjustment variables. Results: The frequency of in-hospital mortality was 14.7%. The mean BMI was found to be 28.2 ± 4.8 kg/m 2 . Considering the in-hospital mortality frequencies between the groups, mortality was observed in 61.7% of the BMI <20 kg/m 2 group, 15.5% of the 20-25 kg/m 2 group, 8.5% of the 25-30 kg/m 2 group, and 9.5% of the >30 kg/m 2 group (chi-square P value <0.001). In the multivariable logistic regression analysis, a change in BMI from 20 to 30 kg/m 2 was associated with a reduced risk of in-hospital mortality (odds ratio: 0.39, 95% confidence interval: 0.23-0.67, P  < 0.001). Conclusion: Our study results revealed that there was inverse significant association between BMI and in-hospital mortality in STEMI patients.