Acute coronary syndrome(ACS) refers to a group of clinical symptoms caused by acute myocardial ischemia, including unstable angina pectoris, acute myocardial infarction, and sudden ischemic death. In recent years, studies have shown that the main mechanism of its occurrence is the rupture of plaque and the consequent intravascular thrombosis. Multiple factors may lead to the occurrence of the disease. However, the mechanism of the histomorphological change from pre-fragmentation to post-fragmentation is still unclear. Vasospasm may also play an important role. Prevention of plaque formation and rupture or prevention of thrombosis by antithrombotic therapy is effective in reducing the incidence of acute coronary syndrome, and coronary intervention also reduces the mortality of acute coronary syndrome. Some new therapies, such as gene therapy, are still in the experimental stage. At the same time, people should improve the awareness of disease prevention, and the most active prevention is the best means of disease treatment.