Guidelines for acute myocardial infarction (AMI) include secondary prevention (SP) strategies, but little is known about patients' recall of instructions following hospital discharge. We conducted telephone interviews to assess recall of risk-reduction information among patients discharged with AMI. Results indicated similar proportions of documented and patient recall of discharge instructions. However, lifestyle recommendations were documented and recalled less frequently than pharmacologic therapy. Many patients were unable to name their diagnosis or link known risk factors as contributing causes, which may contribute to low adherence to SP therapies. Quality improvement strategies are needed to guide more effective provider-patient communication.