Objective: To evaluate the effect of neovascularization of extracorporeal cardiac shock wave therapy in a porcine model in vivo. Methods: Acute myocardial infarction was created by balloon occlusion of left anterior descending coronary artery and two different groups were divided(n=5 each). Real-time myocardial contrast echocardiography was performed before infarction and 1 day, 1 month after infarction. In group A, the shock wave therapy was started 3 days after acute myocardial infarction and applied 9 sessions on 4 segments with low energy(0.09mJ/mm2) at 200 shoots/spot for 9 spots(-1~0~+1 combination) within 1 month and group B was the control group. Results: Within 1 month follow-up, the death rate was 20% and 40% in 2 groups respectively. Neither arrhythmias nor other complications were observed during or after the shock wave therapy. Before infarction, there was no significant differences of regional blood flow valued by A·K on target segments between 2 groups. After infarction, followed at 1 day and 1 month, A·K decreased significantly before and after self control in both groups(P<0.05). In group A, A·K was higher on 4 segments compared with the group B(P<0.05). And the blood perfusion of the middle region improved better than that of the apex region(86.57% vs 65.54%). Whereas group B had little change. Conclusion: These results suggest that our extracorporeal cardiac shock wave therapy is a safe, non-invasive treatment in promoting angiogenesis that was associated by a substantial increasing of regional blood perfusion in a porcine model of acute myocardial infarction.