Myocardial infarction is one of the most important causes of mortality and its incidence exhibits a significant circadian pattern with a peak of maximum frequency between 10 am and 11 am. Furthermore, myocardial infarction size and related mortality rate also undergo a variation over 24 hours. Recent publications have shown greatest myocardial injury when symptoms onsets are around midnight and this was independent of ischemic time and quality of care. These data were corroborated by studies using experimental models that unravel correlation between myocardial infarction's size and genes involved in circadian rhythm the link between circadian biology and pathophysiology of ischemia provides a new era of cardiovascular research and in addition new potential therapeutic targets to prevent myocardial ischemic burden.