So far, no studies have been performed regarding the epidemiology and management of acute coronary syndromes (ACS) in Cyprus. The aim of the present study was to enroll a representative sample of patients in order to study the epidemiology and management of ACS in the Mediterranean island of Cyprus.For a period of 12 months, all patients admitted to Nicosia General Hospital with an ACS were studied. The calculation of the annual incidence of ACS was based on the number of all ACS cases registered during one year in the Nicosia district. The results from the province of Nicosia can be considered as representative of the whole ACS profile in Cyprus.The annual incidence of ACS in the Nicosia district was 160 per 100,000 inhabitants (41 per 100,000 women and 282 per 100,000 men). This percentage translates into 1342 ACS episodes annually among the Cypriot population. The ratio of men to women was 6.8:1. More female ACS patients than men had hypertension (67.3% vs. 46.3%, p=0.005) and were passive smokers (53.8% vs. 47.7%, p=0.4), while male patients with ACS included a significantly greater percentage of smokers compared to women (51.3% vs. 13.5%, p<0.001). Regarding the type of ACS, 45% of patients were diagnosed with STEMI, 41.3% with NSTEMI and 13.7% with unstable angina. The majority of patients with STEMI were treated with medical reperfusion. The in-hospital mortality rate was 3.5%.The annual incidence of ACS in Cyprus is below the European average. The management of ACS is similar to that in southern Europe. The majority of patients with STEMI are treated with pharmacological reperfusion. The small geographical area of the island provides the advantage of early reperfusion to the majority of patients, which results in very low in-hospital mortality.