Italy has been one of the first countries in Europe to perform primary percutaneous coronary intervention (p-PCI) and some regions are still a model for the ST-elevation myocardial infarction (STEMI) network organization. However, in Italy, as in other European countries, some regional disparities emerge that are related to geographical, economic, organizing, and structural issues. Although some regions have excellent STEMI networks, others still have to optimize their models allowing to each STEMI patient to receive the best reperfusion treatment. The RETE IMA Web surveys documented that extraordinary advances have been made in the recent past in Italy in development of STEMI networks, in part thanks to the activity of the Stent for Life project. Indeed, the current annual rate of p-PCI/million inhabitants in 2016 is quite compliant with the standards recommended from the European Society of Cardiology.