Background: There has been an increase in the prevalence of cardiovascular risk factors associated with acute coronary syndrome (ACS) among people of Indian ancestry, and ACS has emerged as a major cause of mortality in this population. According to the data we have at the moment, young patients account for 0.4% to 19.0% of all ACS cases, depending on the age threshold that is employed. The goal of the current investigation was to determine the prevalence of the most common cause of Acute Coronary Syndrome in young individuals. Methodology: Patients between 25 and 44 years old, of either gender, who were hospitalised with suspected ACS symptoms beyond the upper limit of normal were included in this prospective observational study. Results: The study consisted of total number of 147 cases of young adult of acute coronary syndrome who were admitted Cardiology Unit in tertiary care centre. Patients included in the study of which 112 (76.2%) were male patients and 35 (23.8 %) were female patients. In this study, three different types of acute coronary syndrome were encountered during our study which includes 81 (55.1%) patients are with NSTEMI, 50 (34 %) are with AWMI and 16 (10.9%) are with IWMI. In our study, Smoking & Alcoholic were the major cause for ACS in young patients constituting 78 (53.06%). The ACS patients, prescribed with Anti platelets (97.9%), Anti coagulants (99.3%), HMG-CoA reductase inhibitors (100%), Proton pump inhibitors (100%), Beta blockers (28.5%), Diuretics (13.6%) & Vasodilators (4.08%). Conclusion: Smoking, hypertension, diabetes, dyslipidemia and alcohol consumption were other important modifiable risk factors in young adults. Other risk factors such as family history of premature CAD was also prevalent in young adults.