BACKGROUND Most cases of ACS (Acute Coronary Syndrome) are caused by rupture of an atherosclerotic plaque in a coronary artery, resulting in the formation of a thrombus. Atherosclerosis results from an over balance between radical generating, compared with radical scavenging systems, a condition called oxidative stress. Bilirubin had some role in mechanism of ACS. We wanted to evaluate the association between raised total bilirubin level and GGT levels with different subsets of acute coronary syndrome. METHODS The present descriptive cross-sectional study was conducted at Narayan Medical College and Hospital from July 2019 to April 2020. Total serum bilirubin was measured in the laboratory by spectrophotometry method. Gamma glutamyl transferase levels were measured in all the patients using a standardized photometric method. RESULTS In our study the mean value of triglyceride is 159.86 ± 42.36 with range 60 - 246. Total bilirubin 2.23 ± 0.827, with range 1 - 4. The value of gamma glutaraldehyde was 56.67 ± 26.48 with range 22 - 104. On studying the correlation of serum bilirubin and serum triglyceride in our study subjects, we found very mild correlation with an R square of 0.028. On finding correlation of GGT and serum triglyceride in our study subjects. We found almost no correlation with R square 0. When we do multivariate analysis of effect of serum bilirubin, GGT on total cholesterol level we found that there is very mild correlation with R square 0.031. CONCLUSIONS In our study there was very mild correlation between serum bilirubin and gamma glutamyl transferase with marker of acute coronary syndrome such as serum triglyceride level and total cholesterol level but the association was significant. KEYWORDS Acute Coronary Syndrome, Triglyceride, Bilirubin, Gamma Glutaraldehyde