AcuteCoronarySyndrome(ACS)encompasses unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI), which arise from acute myocardial ischemia due to coronary artery obstruction. ACS is a leading cause of global morbidity and mortality, requiring prompt diagnosis and intervention. Pathophysiology involves plaque rupture, thrombosis, and ischemic injury, exacerbated by systemic inflammation and oxidative stress. Diagnosis is guided by clinical symptoms, electrocardiography (ECG), and biomarkers like high-sensitivity troponins, complemented by imaging tools such as echocardiography and coronary computed tomography angiography (CCTA). Treatment aims to restore perfusion, reduce myocardial damage, and prevent recurrence. STEMI necessitates immediate reperfusion via primary percutaneous coronary intervention (PCI) or fibrinolysis, while NSTEMI and UA management depends on risk stratification using tools like GRACE or TIMI scores. Dual antiplatelet therapy (DAPT), anticoagulants, beta-blockers, statins, and ACE inhibitors form the cornerstone of pharmacological treatment. Recent advancements include newer antiplatelet agents (ticagrelor, prasugrel), lipid-lowering therapies (PCSK9 inhibitors), and hybrid approaches combining PCI and coronary artery bypass grafting (CABG). Challenges persist in timely diagnosis, access to advanced care, and addressing disparities in outcomes. Multidisciplinary care and cardiac rehabilitation are critical for improving long-term prognosis. Emerging technologies, including digital health and AI-driven tools, hold promise for enhancing ACS management. In summary, a comprehensive, evidence-based approach is essential for managing ACS effectively, with ongoing innovation and global efforts aimed at improving equity, access, and personalized care.