INTRODUCTION ABSTRACT Coronary heart disease (CHD) is the major cause of death in developing countries like India. Acute Myocardial Infarction (AMI) is the most important form of CHD. Cardiogenic Shock (CS) is a dreaded clinical condition with a high mortality rate of 50 – 80% in patients of CS due to acute myocardial infarction. It is an established fact that inpatients with CS, complicating acuteMI, one year survival is better in those receiving early revascularisation versus initial medical stabilization; however, data demonstrating longterm survival was lacking. METHODOLOGY 60 Cases of Acute Coronary Syndrome (ACS) presented as cardiogenic shock and 60 patients with Acute coronary Syndrome (ACS) without shock admitted in GGH from September 2015 to September 2016. RESULTS In present study majority of patients presented with anterior wall MI (33% in MI without CS group; 41% in MI with CS group). overall incidence of ventricular tachycardia was 22.5% as compared to retrospective study incidence of arrhythmias (13% to 19%). Elderly age, Obesity, Delayed presentation to hospital, Past history of IHD , High TIMI risk score on presentation and unsuccessful thrombolysis drastically increase the risk of cardiogenic shock in patients with M.I. Incidence of mortality in present study is 13.33% in MI without CS group and 68.33% in MI with CS group, which directly states that cardiogenic shock is strongest predictive risk factor for patients of MI.