Introduction: Acute myocardial infarction (AMI) is one of the most serious manifestations of cardiovascular diseases and has a high prevalence among middle-aged adults. Given this scenario, understanding the epidemiological profile of AMI in adults over 40 years of age is fundamental to supporting prevention, early diagnosis, and clinical management actions, contributing to reducing cardiovascular mortality and strengthening healthcare in Brazil. Objective: This study aimed to outline the profile of deaths from acute myocardial infarction among adults aged 40 to 59 years in the state of Espírito Santo during the period from 2020 to 2023. Method: This is an ecological, cross-sectional, quantitative, descriptive, retrospective study with secondary data collected from the database of the Department of Information and Informatics of the SUS (DATASUS). Results: It was found that 71.5% of deaths correspond to male individuals, regarding race/color 46.87% were mixed race, 47.14% of deaths occurred in the Metropolitan macro-region, and 40.63% occurred at home. Conclusion: A higher prevalence of deaths was found in 2020, among men, in the metropolitan macro-region of the state, of mixed race/color, and at home.