Aim: To examine the incidence and treatment of acute myocardial infarction (AMI) as well as 30-day and 1-year prognoses of patients in three major regions of Hungary by analysing data from the country’s continuous and mandated infarction registry. Methods and results: The total population of Hungary is currently 9.8 million: 39% live in the eastern region (ER), 31% in the Central region (CR) and 30% in the western region (WR). These regions exhibited significant differences in income and people exposed to poverty. Population over 30 years, the age-standardised incidence of AMI was 177.5 (175.7–179.3) per 100,000 person-year. During hospital treatment, 82.5%–84.6% of patients with ST-elevation (STEMI) and 54.8%–81.8% without ST-elevation (NSTEMI) underwent PCI. The total ischaemic time was shortest in WR:221 minutes. In the STEMI group, the 30-day mortality rates of males were lowest in the WR (p = 0.03). If PCI was performed, mortality rates for both sexes were lowest in the WR (p < 0.01; p = 0.04). The 1-year mortality rate in the male population who received PCI was lowest in the WR. In the NSTEMI group, the 30-day mortality rate exhibited no differences. Regarding 1-year mortality, those who underwent PCI in the WR showed the lowest mortality. Conclusion: The major regions of Hungary exhibited significant differences regarding the prehospital delay, the incidence, treatment and mortality of AMI. Logistic regression analysis confirmed the independent prognostic significance of the region on the 30-day mortality of patients with STEMI (Hazard ratio = 0.88, p = 0.0114).