BACKGROUND: There is a debate if patients with history of inflammatory bowel disease (IBD) have higher risk of having acute coronary syndromes (ACS). Several studies have not answered this question. Our study used national data registry called the National Inpatient Sample (NIS) and the size of the target population is the largest sample used to answer the aforementioned question. METHODS: Retrospective analysis for the national inpatient sample data base (NIS). All diagnoses including IBD, ACS, Hypertension (HTN), Diabetes mellites (DM), Smoking, obesity, Alcohol abuse were identified using International Statistical Classification of Diseases and Related Health Problems (ICD9). A univariate and multivariate logistic regression analysis were used to calculate the Odd ratio. T test was used to examine the means. SPSS software version 24 was used for analysis. RESULTS: 57984 admissions with history of inflammatory bowel disease (IBD) were identified using ICD9 codes. Of those, 7894 had Ulcerative colitis (UC), 40628 with Crohn’s, 414 (.0.7%) had acute coronary syndromes (ACS) related admissions. Mean age of patients is 50 plus. 25209 (43.5%) male, 32762 (56.5%) female. 47144 (81.3%) White, 5889 (10.2%) Black, 2941 (5.1%) Hispanic, 523 (0.9%) Asians, 1251 (2.2%) others. Mean length of stay for patient who had ACS related admissions and history of IBD is 5.4 days vs. 4.4 days for people without history of IBD (P = 0.08). A multivariate logistic regression showed that. Patients with history of IBD is less likely to have ACS(P < 000, Odd ratio(OR) = 0.73, 95% confidence interval (CI) = 0.0.669–0.0812 ), Smoking, (P < 0.05, OR = 1.569, 95% CI = 1.540–1.600), HTN (P < 0.005, OR = 2.732, 95% CI = 2.689–2.777), DM (P < 0.005, OR = 1.468, 95% CI = 0.428–1.508), Alcohol abuse (P < 0.05, OR = 0585, 95% CI = 0.56–0.611). There is no inpatient mortality difference between ACS related admission with history of IBD vs people with no history of IBD (P = 0.535, OR = 0.643, 95% CI = 1.60–2.588). CONCLUSION(S): People with inflammatory bowel disease do not have a higher risk for acute coronary syndrome. There is no mortality difference between ACS related admission with or without history of inflammatory bowel disease. ACS related admission with history of inflammatory bowel disease has a longer length of stay but not statistically significant.