Aim: To study the incidence of arrhythmias in the first week of Acute Myocardial Infarction (AMI) with respect to type of arrhythmia, age distribution, sex and location of infarction, various risk factors in a patient population from western India and to evaluate its prognostic value and relation of complications with incidence of arrhythmias. Study Design: A prospective clinical study consisting of 100 patients was undertaken to investigate the relationship of arrhythmia with site of AMI, timing, complications and outcome in terms of mortality and morbidity. Materials and Methods: Hundred cases of AMI with arrhythmia admitted in ICCU of Seth Vadilal Sarabhai General Hospital, Ahmedabad were taken in the study. Results: Among 100 cases, maximum incidence (38%) was found in 6th decade. Incidence of arrhythmias was higher in males (76%) than females (24%). Anterior wall infarcts (57%) were more common than inferior wall (36%). Ventricular Premature Contraction (VPC) was the commonest arrhythmia is anterior wall MI (43.85%) and in inferior wall MI (19.4%). Conclusion: Hence, in one of the largest study of this kind in a patient population of Western India, we established VPC’s as the most common arrhythmia in AMI patients. Older patients (sixth decade) and males are affected more commonly. Ventricular tachycardia is more fatal in acute inferior wall MI.