A b s t r a c t A r t i c l e I n f oIn the presence of increasing risk factors like hypertension, diabetes mellitus, and obesity in our community, acute coronary syndrome appears to be a real health problem. This study aimed to determine the clinical profile and risk factors of acute coronary syndrome among patients admitted to Cardiac Care Unit at Elobied Teaching hospital. This is a hospital-based retrospective study done by reviewing records of 84 patients who were admitted to the Cardiac Care Unit with the clinical diagnosis of acute coronary syndrome from the period July 2014 to November 2015. The data were obtained through well-designed data sheet including age, gender, and residence. Clinical presentation, risk factors like hypertension diabetes and cigarette smoking. The data sheet also included ECG findings, complications and outcome of the patients. The data were analyzed using SPSS version 14. More than half of patients were above 60 years (65%). More than half of patients were males (56%). Chest pain was the predominant presenting complaint (98%). More than half of patients were hypertensive (57%) while one third were diabetic (33%). One third of patients were smokers. Troponin was positive in 63% of patients, ECG was abnormal in 68 % of patients and 61 % of the patients were referred for coronary angiography. This study showed that hypertension, diabetes mellitus and smoking are the major risk factors for acute coronary syndrome, early detection and management of hypertension and diabetes are indicated. Establishment of catheter laboratory in our setting should be given a priority.