The occurrence of myocardial infarction in myeloproliferative disease is mostly attributed to coronary thrombosis due to hyperviscosity and thrombocytosis. We report a 55-year-old man case with polycythemia vera none diagnosed before and revealing with ST-segment elevation myocardial infarction; this is a relative rare association. The clinical status, comorbidities and patient outcome were studied. This case illustrates the importance of early diagnosis of polycythemia vera and research almost systemic thrombotic complications.