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This was a prospective descriptive study for patients with first onset transmural AMI aiming to evaluate serum CRP in patients with first onset of transmural AMI In Aden - Yemen. The study group included 47 patients and 94 controls. Males were more affected than females in all ages after 35 years. Serum CRP was found to be high on admission of patients with AMI, but returns to normal level after one week. Serum CRP in transmural AMI has no relation to sex, but has relation to age, waist measurement, BMI, and overweight. Serum CRP was not affected by Qat chewing but it is affected by smoking. Serum lipids had a significant relationship to serum CRP, but it is less with triglycerides. Serum CRP on admission had a significant relationship to the clinical outcome, and to the 30-day mortality. For prognostic relations, Serum CRP was significantly related to short term prognosis as do the total WBC count, but neither the ESR nor the thrombocytes count do so. In conclusion, serum CRP determination on admission of first onset transmural AMI is of short term prognostic value, the more the elevated the serum CRP on admission, the worst the outcome.