A drug use evaluation was conducted to determine if reteplase was administered expeditiously, appropriately, and safely to patients arriving in the emergency department (ED) with acute myocardial infaction (AMI). A retrospective review of the medical records of 28 patients receiving reteplase in the ED during a 6-month period was conducted. The median door-to-drug time for administration of reteplase was 33 minutes. Major and minor bleeding events occurred in 3.6% and 42.8% of patients, respectively. In general, reteplase was administered correctly and in a timely manner to appropriately screened patients.