Acute ST-Elevation Myocardial Infarction (STEMI) remains a major cause of morbidity and mortality worldwide. While primary percutaneous coronary intervention (PCI) with stent implantation remains the gold standard, mechanical thrombectomy has emerged as an adjunctive method to improve thrombus burden removal, enhance coronary perfusion, and reduce microvascular obstruction. This study evaluates the efficacy, safety, and short-term outcomes of mechanical thrombectomy in acute STEMI patients presenting to a tertiary-level cardiac care hospital. A total of 182 patients were enrolled over an 18-month period and divided into two cohorts: PCI-only (n=92) and PCI + Mechanical Thrombectomy (n=90). Post-procedure TIMI flow grades, myocardial blush scores (MBS), left ventricular ejection fraction (LVEF), and 30-day major adverse cardiac events (MACE) rates were assessed. Results showed significant improvement in TIMI III flow (89.1% vs 73.2%), reduced thrombus burden, and lower incidence of no-reflow in the thrombectomy group. The findings suggest mechanical thrombectomy may provide added clinical benefits but requires careful case selection.