Background: In order to anticipate the common side effects and to direct the treatment choices, risk stratification scores are an essential tool in the management of ST segment elevation myocardial infarction (STEMI) patients. The GRACE risk score (Global Registry of Acute Coronary Events) and the TIMI risk score (Thrombolysis in Myocardial Infarction) are the two most commonly utilized scores for risk stratification in STEMI. The CHA2DS2-VASc-HSF score, which was recently created, was derived from the CHA2DS2-VASc score. Objective: This study aimed to assess the relationship between patients with STEMI undergoing primary percutaneous coronary intervention (PCI) and their admission CHA2DS2-VASc-HSF score and short-term clinical outcomes. Subjects and methods: This prospective observational study was done on 100 consecutive STEMI patients treated with primary PCI at Benha University Hospital and Nasser Institute for Research and Treatment Hospital between December 2022 and April 2023. All patients underwent a thorough medical history, physical examination, ECG, and echocardiography. For each patient, we calculated their TIMI, GRACE, and CHA2DS2-VASc-HSF risk scores. Results: The three risk scores CHA2DS2-VASc-HSF, TIMI, and GRACE were statistically significant predictor of in-hospital 3-point MACE. According to our study, high CHA2DS2-VASc-HSF scores > 4 were statistically significantly associated with cardiovascular mortality, the composite endpoint of 3-point MACE, patients requiring cardiopulmonary resuscitation and patients experiencing cardiogenic shock. Additionally, there was a statistically significant correlation between patients with three vessel disease and high CHA2DS2-VASc-HSF scores > 4. High CHA2DS2-VASc-HSF score > 4 was statistically significantly associated with patients' 30-days death from all causes, lethal re-infarction, and 3-point MACE. Conclusion: Every STEMI patient should be assessed by the CHA2DS2-VASc-HSF score to help identify potential high-risk patients (those with a CHA2DS2-VASc-HSF score > 4 points), who should receive more aggressive therapy and vigilant monitoring.