Objective : To study the change in incidence of hospitalised first acute myocardial infarction (AMI) in the Netherlands from 1995 to 2000. Methods : Patients with a first hospitalised AMI in the Netherlands in 1995 and 2000 were identified through linkage of the national hospital discharge register and the population register. Results : 21,565 patients with a first hospitalised AMI in 1995 and 19,058 patients with a first hospitalised AMI in 2000 were identified. In both years, the age-specific incidence of hospitalised first AMI was higher in men than in women and increased with age (up to ninety years). In both men and women, the age-standardised incidence was lower in 2000 compared to 1995, a decline of 19% (95% CI 17-21%) and 17% (95% CI 14-19%), respectively. Conclusions : Our study provides the first nationwide incidence estimates of first AMI in the Netherlands. From 1995 to 2000, the risk of AMI declined considerably.