Coronary Artery Disease (CAD) is becoming the major cause of morbidity and mortality in the developing world. CAD in Indians is associated with more severe presentation, younger age of onset and shows male preponderance. Objectives: To identify the risk factors and clinical profile of patients of Acute ST Elevation Myocardial Infarction (STEMI). Methods : A prospective study conducted in patients of Acute ST elevation myocardial infarction to find the risk factors, clinical presentation and complications. We enrolled 100 patients with acute myocardial infarction and clinical history, risk factors, duration of symptoms, ECG findings, regions of infarction, rhythm disturbances and complications were documented. Results: Acute ST elevation MI was more common in males (80%) with male to female ratio being 4:1. The most common age group affected was 41–50yrs in males and 51–60 in females. Most patients arrived at hospital within 6 hrs of onset of pain. In the hospital mortality rate was 14 %. Conclusion: The incidence of acute MI is increasing with greater involvement of younger patients and shows male predominance. This highlights the need and importance of health education regarding risk factors, symptom identification and golden hour in reaching the hospital to save the myocardium. It also brings to focus the need for coronary intervention units in peripheries to help the rural people.