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Coronary artery disease (CAD) is the lea ding cause of death Worldwide. Acute coronary syndrome (ACS) is the most feared complication of CAD(1).Chest pain as main presenting symptom.Management based on stabilizing the patient initially, Relieving ischemic pain and providing antithrombotic therapy to reduce myocardial damage and prevent further ischemia,all guidelines directed. Objectives:the aim was to assess the management plan of acute coronary syndrome in Sudanese public hospitals.