Acute myocardial infarction (AMI), also referred to as a heart attack is responsible for one the most prevalent cardiovascular mortality among patients. It is time sensitive with prehospital protocols holding a significant importance. This systematic review aims to assess the effectiveness of prehospital strategy among acute myocardial infarction (AMI) patients. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, which have played a crucial role in maintaining the transparency and thoroughness of this review. The review included five studies that significantly contributed to the importance of prehospital intervention protocols in managing AMI. Direct referral to PPCI centers, rapid prehospital ECG diagnosis, and protocol-driven EMS transportation significantly reduce ischemic time and mortality rates. Prehospital triage improves survival rates and reduces both short-term and long-term mortality. Integrating prehospital and hospital-based care is crucial for optimizing patient outcomes. However, variations in outcomes suggest the need for standardized protocols and continuous training for EMS personnel.