Globally, myocardial infarction (MI) is a leading cause of mortality and disability. Early detection of ischemia myocardium has consequences for prognosis and treatment. It is still challenging to evaluate right heart function in spite of rapid advances in technologies. Objective: this study aimed to evaluate the improving right ventricle function (RV) in patients with acute inferior MI. Patients and methods: This prospective study included 50 patients who admitted with inferior wall myocardial infarction (IWMI). Patients were subjected to resting 12-lead standard surface electrocardiogram, transthoracic echocardiography (TTE), coronary angiography and primary percutaneous coronary intervention (PCI). Results: 74% of studied cases were males with mean age of 62.1 years, 42% of them had positive family history. Risk factor found among studied cases was diabetes mellitus (60%), 54% had hypertension, 52% with dyslipidemia and 50% were obese. Only one stent used for 90% of studied cases during PCI, while 10% of them had two stents. There was a high significant improvement in RV function parameters (RVDD, PASP, TAPSE, RVFAC and TR), myocardial performance index and S wave post PCI. There was a high significant improvement in RV diastolic function grading, as 50% of studied cases had impaired function pre-operative changed to 8% only and 74% of the cases become normal after PCI. Also, 62% of studied lesions were proximal, 24% proximal to mid and 8% proximal para-osteal. Conclusion: Primary PCI of proximal right coronary artery can improve right ventricular systolic and diastolic dysfunction in patients with acute inferior wall myocardial infarction.