The approach to acute MI and heart failure has changed, and the focus has shifted on trying to achieve what was previously unthinkable: To reconstitute dead myocardium. In light of the above, we assessed the effect of Intra-Coronary delivery of Autologus Bone Marrow Stem Cells on left ventricular functions at short term (6 months) and long term (3 years) follow-up periods in patients with acute ST segment elevation myocardial infarction (STEMI) with no evidence of reperfusion i.e. neither subjected to primary PCI nor thrombolysis or received thrombolysis but without evidence of success. Bone marrow was aspirated from the iliac puncture, prepared in the laboratory for isolation of mononuclear cells then delivered intracoronary in the active patient group. Patients then was then monitored closely then followed up clinically every 3 month with full assessment at 6 month and 3 years or when necessary according to methodology protocol. Our study was conducted on 23 out of 42 patients, split into two groups, Active group (G.1) consisted of 13 patients and control group (G. 2) consisted of 10 patients. All patients sustained either anterior or anterolateral MI. 38.5% patients in Group 1 and 30% patients in Group 2 suffered from post MI heart failure (NYHA FC III-IV) and 84.6% patients in Group 1 and 90% patients in Group 2 suffered from post MI angina prior to revascularization.