The use of enzyme analysis has proved considerably valuable in the diagnosis of myocardial infarction. 2. Serial studies of multiple enzymes appear to lend greater specificity and sensitivity to such testing. 3. Creatine phosphokinase appears to be the most useful of the conventional enzymes employed in the diagnosis of myocardial infarction, but limitations due to technical factors and other clinical states causing elevation must be recognized. 4. Current studies to enhance the specificity of enzyme diagnosis in myocardial infarction include the employment of isoenzymes of CPK and LDH. 5. Enzymes appear to afford significant benefit in assessing the prognosis following myocardial infarction and may aid in the selection of therapy.