Background: The first coronary care units were established in the early 1960s in an attempt to reduce mortality from acute myocardial infarction. The modern era of aggressive management of ACS was introduced by the establishment of the CCUs, and later by the development of reperfusion therapies, which led to a reduction in death rates of STEMI from 30% or more to less than 10%. Coronary care units (CCUs) should ensure the best intensive therapy for all critical cardiologic patients and not only for patients with acute coronary heart disease. Objective: Registry of all patients admitted to El-Manial specialized hospital CCU during the period of the study from 1/4/2008 to 31/3/2009 to determine the pattern of admission of the cardiac and non-cardiac cases, Determine the in hospital mortality, Follow up of patients admitted to the coronary care unit during the period of the study, Determine the percentage of patients admitted to the coronary care unit with STEMI vs. NSTEMI during the period of the study and the percentage of patients with STEMI who received thrombolytic therapy during the window period.Methods: 473 cases were included in this study & divided into 2 groups: Cardiac group : 440 cases, Non- cardiac group : 33 cases.Clinical evaluation: History taking (age, gender, risk factors), Full clinical examination.Admission diagnosis, Hospital stay, discharges diagnosis.Results: ACS patients constitute the majority of patients. All patients with ACS underwent extensive investigations including coronary angiography. PCI was done to 62% of cases who underwent coronary angiography, medical treatment was recommended to 22%, CABG was recommended to 9%, and normal coronary angiography was found in 7% of cases. Thrombolytic therapy was given 66% of acute STEMI cases in the CCU and to 7% in the emergency department. Congestive heart failure and serious rhythm disturbances constituted a second more common cause for admission to the coronary care unit. Overall mortality rate was 6.7% suggesting high level of care in this high risk group of patients. Conclusion: ACS patients constitute the majority of patients. All patients with ACS underwent extensive investigations including coronary angiography. PCI was done to 62% of cases who underwent coronary angiography, medical treatment was recommended to 22%, CABG was recommended to 9%, and normal coronary angiography was found in 7% of cases. Thrombolytic therapy was given 66% of acute STEMI cases in the CCU and to 7% in the emergency department.Congestive heart failure and serious rhythm disturbances constituted a second more common cause for admission to the coronary care unit. Overall mortality rate was 6.7% suggesting high level of care in this high risk group of patients.