Background: Shorter door to balloon times are associated with improved outcomes in patients suffering from ST-elevation myocardial infarctions (STEMI). To determine whether prehospital activation of a new regional Australian cardiac catheterisation Laboratory (CCL) reduced pain to balloon time (PTBT), fi rst medical contact to balloon time (FMCTBT), activation of CCL to balloon time (ATBT) and door to balloon time (DTBT). Methods: 200 patients suffering from STEMI who presented to a new regional Australian CCL over a 19 month period were analysed. Prehospital activation (PHA) involved ECGs being performed and interpreted by paramedics who then contacted the on call interventional cardiologist to activate the CCL thus bypassing the emergency department. Hospital activation (HA) involved emergency physicians reviewing patient and activating CCL. Statistical analyses of PTBT, FMCTBT, ATBT and DTBT between these groups was undertaken with SPSS version 22. Results: 77% (154/200) were male, mean age 64 years (36-93 years), 40% (80/200) were prehospital activation STEMIs. There was a signifi cant difference between the following times: PTBT [PHA (163.5mins [IQR: 130,232.7]) vs HA (240mins [IQR:175.5, 413.5]) p=0.000]; FMCTB [PHA (103mins [IQR: 85, 122]) vs HA (152.5 mins [IQR: 109.5, 228.8]) p=0.000]; ATBT [PHA (64mins [IQR: 48, 76.8]) vs HA (71mins [IQR: 57.3, 103.8]) p=0.004]; DTBT [PHA (34.5mins [IQR: 28, 51.8]) vs HA (64mins [IQR: 33, 100.8]) p=0.000]. Conclusions: Prehospital activation of the CCL by paramedics was associated with a signifi cant reduction in times to presentation to a CCL in a regional Australian STEMI population.