Background: Left ventricle (LV) remodeling and poor myocardial reperfusion have been linked in various investigations, particularly in diabetics. Objective: The aim of this study was to assess the influence of diabetes mellitus on both left ventricular systolic function recovery as well as myocardial reperfusion following primary percutaneous coronary intervention (PCI). Patients and methods: One hundred primary percutaneous coronary intervention of (IRA) alone was used in 50 diabetic and 50 nondiabetic individuals who had their first STEMI attack, underwent echocardiography (conventional TTE) and coronary catheterization to determine effect of diabetes on LV remodeling and myocardial reperfusion. Results: ST elevation after 1ry PCI in diabetics differed significantly compared to non-diabetics. Left ventricular end-systolic diameter (LVESD), wall motion score index (WMSI) and incidence of remodeling after 3 months follow up was significantly higher in diabetic group compared to non- diabetics. Follow up beyond 3 months indicated  positive significant correlation between ejection fraction (EF) by m-mode and myocardial blush grade (MBG), negative correlation between LVEDV and MBG, positive significant correlation between E/A ratio and MBG negative significant correlation between WMSI and MBG. Conclusion: It could be concluded that diabetes has a negative impact on cardiac reperfusion in STEMI patients. Patients with diabetes are more likely to experience remodeling than those without diabetes.