Background: Elevations of hepatic transaminase (serum alanine transaminase [ALT] and serum aspartate aminotransferase [AST]) levels in patients with acute coronary syndrome (ACS), although transient, may result in exclusions from clinical efficacy trials due to suspected liver disease. So, this study aimed to evaluate the value of hepatic transaminases as predictors of in hospital mortality and complications in patients admitted for acute coronary syndrome. Patients and Methods: This cross-sectional study was carried out in the Cardiology Department, Faculty of Medicine, Zagazig University and in the Nasser institute for Research and treatment, Egypt. The study was conducted on 200 patients with acute coronary syndrome, they divided into three groups according to the diagnosis with unstable angina (13.5%), NSTEMI (14.5%) and STEMI (72%). Results: There was significant difference in Liver enzymes (AST and ALT) between all groups. The percentage of patients who had AST ≥2 ULN and ALT ≥2 ULN was significant increase in STEMI group. There was significant increase in Liver enzymes (AST and ALT) in non-survivors other survivors group. The percentage of patients who had AST ≥2 ULN and ALT ≥2 ULN was significant increase in non-survivors group. There were significant increase in cardiac enzymes (CK-MB and CK), in non-survivors other survivors group. There was no significant difference in Alkaline phosphatase in non-survivors other survivors group Conclusion: ACS patients had significantly increased hepatic transaminases levels. Moreover, increased risk of in-hospital all-cause mortality was significantly associated with increased levels of hepatic transaminases.