Background: Aim of the study: To study the demographic profile, risk factors and angiographic profile of patients with acute coronary syndrome. Material and method: A total of 765 patients with acute coronary syndromes who underwent Coronary Angiography (CAG) from 1st April 2022 to 30th September 2022 at Krishna Hospital and Medical Research Centre, Karad were analysed. Their demographic profile and coronary risk factors were compared with their angiographic profile. Results: Of total 765 patients with acute coronary syndrome, 461 (60.3%) were males and 304 (39.7%) were females and the mean age of the study population was 58.99 (± 12.09) years. A majority of 235 (31.1%) subjects were aged between 51-60 years. Hypertension (41.7%) followed by tobacco chewing (35.6%) were the most common coronary risk factors. A majority of 349 (45.6%) patients had non-ST elevation myocardial infarction followed by 161 (21%) patients with unstable angina. Of the 255 (33.4%) patients with ST-elevation myocardial infarction, 88 (11.5%) patients had anterior wall myocardial infarction followed by 72 (9.4%) patients with inferior wall myocardial infarction. Single vessel disease (27.2%) was the most common angiographic profile observed, followed by double vessel disease (21.6%) and triple vessel disease (19.7%). The month of September had the highest number of patients admitted with acute coronary syndromes, with the majority of 49 (27.8%) having single vessel disease and the month of July saw the lowest number of patients (14%). The left anterior descending artery (LAD) was the most involved vessel, seen in 400 (52.3%) patients, followed by the right coronary artery (RCA), seen in 289 (37.8%) patients. The most common site of obstruction was the mid LAD (34.5%). Conclusion: Present study depicted the frequent occurrence of acute coronary syndromes in men in their fifth decade with hypertension and tobacco chewing being the most frequent coronary risk factors. Non-ST elevation myocardial infarction was the most common acute coronary syndrome. Single vessel disease, with LAD was the most diseased coronary artery on CAG.