Epidemiological studies have shown a correlation between flavonoid-rich diets and improved cardiovascular prognosis. Cocoa contains large amounts of flavonoids, in particular flavanols (mostly catechins and epicatechins). Flavonoids possess pleiotropic properties that may confer protective effects to tissues during injury. We examined the ability of epicatechin to reduce short and long-term ischemia reperfusion (IR) myocardial injury. Epicatechin (1mg/kg/day) pre-treatment (Tx) was administered daily via oral gavage to male rats for 2 or 10 days. Controls received water. Ischemia was induced via a 45 min coronary occlusion. Reperfusion was allowed until 48 h or 3 weeks while Tx continued. We measured infarct (MI) size (%), hemodynamics, myeloperoxidase (MPO) activity, tissue oxidative stress, and matrix metalloproteinase-9 (MMP-9) activity in 48 h groups. Cardiac morphometry was also evaluated in 3 week groups. With 2 days of Tx, no reductions in MI size occurred. After 10 days, a significant ~50% reduction in MI size occurred. Epicatechin rats demonstrated no significant changes in hemodynamics. Tissue oxidative stress was significantly reduced in the epicatechin group vs. controls. MMP-9 activity demonstrated limited increases in the infarct region with epicatechin. By 3 weeks, a significant 32% reduction in infarct size was observed with Tx, accompanied with sustained hemodynamics and preserved chamber morphometry. In conclusion, epicatechin Tx confers cardioprotection in the setting of IR injury. The effects are independent of changes in hemodynamics, are sustained over time, and are accompanied by reduced levels of indicators of tissue injury. Results warrant the evaluation of cocoa flavanols as possible therapeutic agents to limit ischemic injury.