The aim of this study was to compare the image quality of a saturation-recovery gradient-recalled echo (GRE; TurboFLASH) and a saturation-recovery SSFP (SR-TrueFISP) sequence for myocardial first-pass perfusion MRI. Eight patients with chronic myocardial infarction and 8 volunteers were examined with a TurboFLASH (TR 2.1 ms, TE 1 ms, FA 8 degrees ) and a SR-TrueFISP sequence (TR 2.1 ms, TE 0.9 ms, FA, 50 degrees ) on a 1.5 T scanner. During injection of 0.05 mmol/kg BW Gd-DTPA at 4 ml/s, three short axis slices (8 mm) of the left ventricle (LV) were simultaneously scanned during breath-hold. Maximum signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) between infarcted and normal myocardium, and percentage signal intensity change (PSIC) were measured within the LV lumen and in four regions of the LV myocardium for the three slices separately. For the LV lumen, SR-TrueFISP was superior in SNR and PSIC (factor 3.2 and 1.6, respectively). Mean maximum SNR, PSIC, and CNR during peak enhancement in the LV myocardium were higher for SR-TrueFISP compared with TurboFLASH (factor 2.4, 1.25, and 1.24, respectively). The SNR was higher in the septal portion of the ventricle than in anterior/posterior and lateral regions. The SR-TrueFISP provides higher SNR and improves image quality compared with TurboFLASH in first-pass myocardial perfusion MRI.