Background: The incidence of arrhythmic complications in Egyptian patients with acute coronary syndromes (ACS) has not been previously reported. The present study results will serve as the local database for future studies. Aim: To evaluate the incidence of arrhythmic complications in ASC among Egyptian patients and to identify factors that may affect arrhythmia complications in ACS patients. Material and Method: Data collected from 400 patients admitted to cardiology department of Suez Canal University Hospital from 1 January 2009 to 31 December 2011, who were diagnosed as having acute coronary syndrome. This registry includes patients who presented with ACS including ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA). Results: The study showed that the majority of patients (79.3%) were males of mean age 54.5+10 years, and 70.9% were STEMI. The highest morbidity and mortality were noticed in those of STEMI 25.6% for morbidity and 4.4% for mortality , and those of anterior myocardial involvement 77.7 for morbidity and 56% for mortality. Arrhythmia was present in 74.6% of study population, 57.6% of them were tachyarrythmia, while 26.4% were bradyarrhytmia. The incidence of VT was higher in the younger age group, while AV block and arrhythmic death were higher in the older aged patients. The incidence of different types of arrhythmia was as follows: PVC (39.5%), PAE (19.5%), AF (16.8%), HB (10.1%), VT (9.6%), arrest (asystole) (8.5%), VF (8.1%), RBBB (6.3%), LBBB (4.3%) and Nodal rhythm (3.1%).Our demographic characteristics, risk factors for both ACS and those who had arrhythmias were the same. The patients were younger, smokers, suffering mainly of hypertension, they were more prone to arrhythmias incidence, because they were smokers, mostly STEMI, and of anterior myocardial involvement. Conclusion: Arrhythmias complicating ACS are associated with higher in-hospital mortality.This study showed that the current management strategy is so adherent to guidelines, but deficient for proper arrhythmias management.