Background: One third of global deaths are caused by CVD, and the most common is IHD. Approximately 80% of IHD which is caused by atherosclerosis, with the remainder caused by non-atherosclerotic causes such as VHD, radiation, vasculitis, and other.Aim: To study the prevalence of ACS in Avicenna Balkhi Teaching Hospital. Methods: This is a retrospective cross sectional study, we collected data of 180 ACS patients from 01.01.2019 till 01.06.2019 in Avicenna Balkhi Teaching Hospital; data was evaluated on clinical traits, treatment, and outcome in ACS patients.Results: 180 patients of ACS admitted during the first six months of 2019. From the aforementioned ACS%, 62.7% (113) were STEMI and 37.2% (67) were NSTEMI/UA, with a male to female ratio was 2.64:1. 66.7% of patients had an age of 60 -79 years. The mean time of patients' admission in CCU was15.5h and was higher in NSTEMI/UA than STEMI (18.3 h vs 11.8 h) respectively. Treatment of all ACS patients such as STEMI, NSTEMI, UA was the same in 90% and received antiplatelet, statins, anticoagulants, anxiolytics. 30,4% of STEMI patients received thrombolytic therapy with streptokinase (which is available in Afghanistan), just 10% from 30.4% we saw the effective role of streptokinase. The most common comorbidity diseases include; Hypertension 45.6%, DM 22.2%, Smoking 27.8%, Heart failure 21.7%, COPD 5.6%.Conclusion: Most of the ACS patients were STEMI, which was more male than female. More than 50% of patients had an age of 60-79 years old, the mean time of admission in the CCU room was more than 10, and the most common comorbidities were HTN, smoking, DM and heart failure. Increasing public awareness of heart disease, expanding professional medical staff capacity, and outfitting the cath lab and cardiac surgery ward. Finally, this study will serve as a resource for future research.