1. To assess whether patients with acute coronary syndromes have received optimal evidence based secondary prevention medications during discharge in accordance with the American heart association/American college of cardiology (AHA/ACC) guidelines. 2. To assess whether beta-blockers, statins and ACE inhibitors/angiotensin II receptor blockers, where prescribed at target dose according to (AHA/ACC) guidelines. in this observational study, retrospective patient data was collected from the hospitals discharge summary, after meeting the inclusion criteria and documented in a standard data collection form. the adherence to (AHA/ACC) guidelines was then compared and evaluated. The compliance results in this study came around 52(73.2%), in which 38(53.5%) received all five medications according to guidelines and 14(19.7%) received less than five medications with valid contraindications. 19(26.7%) patients didn’t receive medications according to guidelines. Patients diagnosed with STEMI had the highest share of receiving all five medications, with 27 patients receiving all medications and patients with unstable angina had the least with 0 patients. The most prescribed class of drugs in this study was the P2Y12 receptor inhibitor (clopidogrel, ticagrelor and prasugrel) with 94.3% and ACE/ARBs were the least with 54.9%. however only few patients were prescribed with target dosing of statins. Approximately, three out of four patients received optimal secondary prevention medication in line with ACC/AHA guidelines. However only few patients were prescribed with target dosing of statins. A promising finding that still has room for improvement by implementing quality improvement strategies and further research to optimise prescribing. This might include greater involvement of clinical pharmacist within the cardiology multidisciplinary team. Note: the study population for this study was supposed to 200 patients, but due to covid-19 pandemic the study stopped temporarily, an increase in the population size might be seen in the day of presentation, as if the situation permits more patients will be added.