Introduction: The incidence of Acute Coronary Syndrome (ACS) in the young population has begun to rise. There is not enough data regarding the characteristics of young patients with ACS. Aim: To evaluate risk factors, clinical and angiographic profile of young patients with ACS. Materials and Methods: A prospective observational study was conducted from December 2017 to December 2020 at SSWH, Burdwan Medical College and Hospital, Burdwan, West Bengal, Kolkata, India among 100 patients. Patients with ACS and aged =45 years were enrolled in the study. Patients were divided into two groups: patients with and without obstructive Coronary Artery Disease (CAD). Clinical parameters and coronary angiography data were collected and analysed. The p-value <0.05 was considered significant. Results: The mean age of the study participants was 37.42±5.18 years, and 82 (82%) participants were male. Smoking was the most common risk factor observed in 71 (71%) of the study population, and the majority of these patients had obstructive CAD. The young population suffered more with a high incidence of ST-segment Elevation Myocardial Infarction (STEMI), with 37 (56.06%) had Anterior Wall Myocardial Infarction (AWMI). When analysed angiographically, Obstructive CAD was most commonly found 82 (82%); among those with obstructive CAD, Single-vessel diseases were predominant in 47 (47%) individuals. The percentage of stable angina was significantly higher among patients with obstructive CAD (53.6%) compared to non obstructive CAD (11.1%), (p=0.001). Conclusion: Two leading risk factors, smoking, and tobacco, were significantly associated with the onset of young ACS. The prevalence of single-vessel disease was higher in young patients with ACS compared to double and triple-vessel disease. [ABSTRACT FROM AUTHOR]