--Introduction: The Acute Myocardial Infarction (AMI) is part of the acute coronary syndrome (ACS), a term that groups a wide range of diseases of chest pain of ischemic origin. The quality of health services becomes fundamental to diminish the impact of this disease, once presented, and differences in health outcomes that occurred from this disease may account for the disparities in the quality of health services provided. Objective: The purpose of this article is to describe health disparities in standardized mortality rates of Acute Myocardial Infarction among patients affiliated to different regimens within the health system (subsidized regimen (SR) versus contributive regimen (CR)) by departments in Colombia between 2005 - 2008. Methodology: Ecological Study. Standardized mortality rate by age (SMR), global and by departments were estimated from 2005 to 2008. Comparison were done using the attributable fraction (AF). Results: SMR for AMI have been declining during the study period. However, disparity in mortality for AMI showed a risk excess between 5.8 % and 68.8 % in SR compared with CR within the departments. Between the departments the SR had an excess risk between 1.57% and 81.01 %, whilst CR had an excess risk between 59.58% and 91.93%. Global SMR for country has been declining too during the study period although there were differences when the AF was estimated with the study data compared with WHO data. Conclusion: There are several disparities in SMR for AMI between different regimens of affiliation to the health system in Colombia among and within the departments suggesting disparities in quality of care between them.