Introduction: Acute coronary syndrome (ACS) is common in serving personnel and requires prompt diagnosis and treatment. This retrospective study was done to see the profile of ACS in serving personnel presenting to a tertiary hospital without cardiac catheterization laboratory (CCL) facilities. Methods: ACS was diagnosed based on an electrocardiogram (ECG), clinical features, and cardiac biomarkers. History of comorbidities, risk factors, and preceding exertion was taken. Immediate medical management was done as per the standard guidelines, and follow-up angiography was done at a dependent cardiology center with CCL. Results: A total of 75 personnel reported with ACS. The mean age of personnel was 42.01 ± 8.59 years. Acute ST-elevation myocardial infarction (STEMI) was noted in 48% (36/75) of the patients, 32% (24/75) had non-STEMI, and 20% (15/75) had unstable angina (UA). Low ejection fraction was more common in patients with STEMI (P ≤ 0.001). History of preceding exertion was noted in 55 personnel. Eighteen patients with STEMI were thrombolysed. Angiographically significant lesions were noted only in 30.6% (23/75) individuals with ACS. Conclusion: ACS is common in deployed serving personnel. The most common precipitators were immediate preceding exertion and smoking. Morbidity and mortality due to ACS can be decreased by digital transmission of ECG, prehospital thrombolysis, graded physical exertion, and counseling about a healthy diet.