Mechanical complications after acute myocardial infarction, including left ventricular free wall rupture, ventricular septal rupture, papillary muscle rupture, and pseudoaneurysm, although infrequent, are associated with significant morbidity and mortality. Despite the reduction in incidence because of early reperfusion therapies, their associated mortality rates remain disproportionately high. This disparity highlights the critical need for early detection and prompt intervention, which are key to improving patient outcomes in the postinfarction period. Timely restoration of coronary blood flow is essential for preventing complications, with reperfusion strategies, particularly percutaneous coronary intervention, serving as a cornerstone in minimizing ischemic injury. This review aims to provide an in-depth evaluation of the clinical, diagnostic, and therapeutic approaches to these mechanical complications with illustrative case studies to facilitate practical understanding of these conditions.