Acute coronary syndrome rarely occurs in young individuals and is seldomly associated with antiphospholipid syndrome. We report the case of a 26-year-old Hispanic man who presented with acute ST-elevation myocardial infarction and was treated with urgent percutaneous transluminal coronary angioplasty. He experienced stent thrombosis within 48 h of intervention and subsequently developed a left apical thrombus. Hypercoagulable state studies were obtained at admission and 12 weeks after the event establishing the diagnosis of antiphospholipid syndrome.