Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. Risk factors of mortality in patients with AMI have been widely investigated, identifying older age and heart failure as common contributors. This study aimed to determine risk factors and explore predictors associated with higher mortality among patients with AMI. A retrospective study was conducted at a cardiac center in western Saudi Arabia (KSA) between January 1, 2023, and September 1, 2023. Inclusion criteria comprised patients with a confirmed diagnosis of AMI. Exclusion criteria included patients younger than 18 and those with incomplete diagnostic or follow-up data. A data collection form was generated, including all possible factors associated with mortality among patients with AMI. The study included 851 MI patients with a mean age of 58.78 years, primarily male participants. Survival analysis based on the days of hospitalization revealed that 30-day and 60-day survival rates post-hospitalization were 66.8% and 33.4%, respectively. Patients with acute MI of the anterior wall or other specific sites demonstrated significantly higher risks of mortality compared to those with unspecified acute MI. Elevated creatine kinase-myocardial band (CK-MB) levels and blood urea nitrogen (BUN) were also significantly associated with increased mortality risk. The findings highlighted an association between mortality and diabetes mellitus (DM) and transmural MI of the anterior wall. Significant differences between surviving and deceased patients were observed in several factors, including troponin, CK-MB, low-density lipoprotein (LDL), BUN, creatinine levels, age, and hospital stay duration.