Myocardial postconditioning (POC), defined as intermittent interruptions of blood flow at the onset of reperfusion after sustained ischemia, may attenuate reperfusion injury. In order to weigh the current evidence linking POC to reduction of myocardial infarct size in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI), we performed a systematic review and meta-analysis of the available data from small randomised trials.