ACS is a set of signs and symptoms due to rupture of a plaque which is a consequence of platelet rich coronary thrombus formation. Thrombus leads to partial or complete coronary artery occlusion which inturn leads to myocardial ischemia and various clinical manifestation ranging from UA to acute myocardial infarction. Conventional risk factors include smoking, diabetes mellitus, hyperlipidemia, obesity and stress which either act singly or in combination increase the chances of developing coronary atherosclerosis.4 Platelet indices also vary in diseases like diabetes, hypertension, obesity, hyperlipidemia etc.,5 This study aims to study the role of platelet parameters in patients with acute coronary syndrome and those who are at higher risk in comparison with healthy individuals. Conclusion: These larger platelets can be easily identified during routine hematological analysis. For this purpose, we think that MPV measurement, in which is a non–invasive and easily available test, it may be an important tool predicting an impending acute coronary event and helping in early intervention to manage such patients.