The most common presentation of Coronary artery disease (CAD) is acute coronary syndrome (ACS). The clinical and angiographic profile of young patients with CAD can differ significantly from those of older patients. Our objective was to study the clinicoangiographic profile and In-hospital outcomes of the patients presenting with acute coronary syndrome (ACS) to our center. Our study was aretrospective study and patients were enrolled from our center. We analyzed the medical records of the patients presenting with acute coronary syndrome (ACS) to our hospital for two years between 01.01.2023 and 01.01.2024. Our study showed obesity, smoking, family history of premature coronary artery disease (CAD), and substance abuse are common risk factors of acute coronary syndrome (ACS) in younger populations whereas in older patients hypertension and diabetes mellitus remain the most common risk factors. Anterior wall myocardial infarction is the most common presentation of ACS in young patients, and single vessel disease (SVD) is the most common CAD pattern on angiography. The In-hospital outcomes of younger patients are better as compared to the older patients.