Patients with AMI usually present with the specific changes for electrocardiogram (ECG) and biomarkers of cardiac injury. Here, we present a rare case with chest pain and normal ECG and biomarkers of cardiac injury. Emergent coronary angiography revealed an occlusion of proximal left anterior descending coronary artery. The patient was diagnosed with AMI, and his symptom relieved after implantation of drug-eluting stents. Caution should be exercised for the exclusion of AMI in patients with chest pain and both normal ECG and biomarkers of cardiac injury.