Cocaine is considered the second most frequently used illicit drug and the most frequent cause of drug-related deaths in the world. Worldwide, the majority of cocaine users are younger people between the ages of 16 and 26 years old; and 11% of the general population is thought to have used it at some point in time. Cocaine users primarily administer cocaine orally, intranasally, intravenously, or by smoking it. Cocaine abuse leads to serious complications that involve all body systems, especially the cardiovascular system. In this study, we reported a case of acute myocardial infarction in a young patient without known chronic diseases. Twenty years old male patient presented with acute epigastric pain and repeated vomiting. He has a two-year history of cocaine abuse. All routine investigations were rapidly done; however, the patient collapsed and cardiopulmonary resuscitation (CPR) was performed. Clinical outcome: the patient, unfortunately, died after all trials to save his life and was diagnosed with severe myocardial infarction.