Background: Patient with lateral wall changes in inferior wall myocardial infarction (MI) usually ignored most often. However above lateral MI changes in the clinical setting of inferior wall MI usually impact on final clinical outcome and prognosis of the patients. Our aim of the study is observe diversity in clinical profile of inferolateral MI in comparison to patient with inferior wall without any lateral wall MI changes.Methods: Current study enrolled 405 patients admitted to cardiology emergency with inferior wall MI. Patients divided into three groups on the basis of ECG changes, inferolateral (group A), isolated inferior wall MI (group B) and inferior wall MI with RVMI (group C). Patients with RVMI (group C) excluded from the group. Clinical profile and outcomes compared between group A and B.Results: Around 33.8% pts with inferior wall STEMI have ECG changes of lateral wall AMI. STEMI equivalent in lead V1, V2 which is the most common ECG presentation, seen in 65% inferolateral patients. 45.7% of population of inferolateral MI are above age group of 60 years. 66.2 % of the patients with inferolateral MI having two or more risk factors. Dyspnoea is one of common symptom seen in 29.9% patients. Statistically significant number of patients in inferlateral MI have clinical picture of LVF (crepitation, S3), higher Killip class as compared to inferior wall MI. Incidence of complications like LVF, MR, VT, death is significantly higher in this group.Conclusions: Around 1/3rd patient with lateral MI changes seen in inferior wall MI patients. STEMI equivalent changes in anterior precordial leads are most common ECG presentation. More no patients are older and with multiple risk factors. Complication and death are higher in this group. So meticulous attention should be given to patients with lateral wall MI changes in inferior wall MI.