Background: The most important clinical factors of in–hospital mortality in STEMI are killip class, age, Blood pressure and heart rate and diabetes mellitus. In contrast, systemic hypertension with left ventricular hypertrophy has modestly favourable impact our in–hospital mortality in patients with STEMI. Methods: Patients were included in this study if they fulfilled the following criteria. Patients with Acute STEMI within seven days of MI. Demographic, clinical, diagnostic, management and survival data were obtained and recorded. Age and Sex distribution, risk factor distribution, Hypertension diabetes, dyslipidemia, smoking, family history of premature CAD was identified and recorded. Results: A total of 705 patients were enrolled and number of patient in survival group 662 and in mortality group 43.Out of 705 patients,322 patients received Thrombolytic therapy(46.2%) among which 282 patients (89.2%) survived and 40 patients (10.8%) died. Thrombolytic therapy was successful (>50% resolution) in 110 patients. Significant 12.23% number of patients who had successful Thrombolysis survived (34.8 %) few deaths (10%) occurred after successful Thrombolysis. Conclusion: In conclusion, the electrocardiographic characteristics associated with higher in hospital mortality are ST segment resolution <50%, ST depression is in non infarct leads and arrhythmias. Bedside 2 dimensional and Doppler Echo cardiogarphy provides additional prognostic information over clinical and biological parameters that are routinely determined in patients presenting with STEMI.