Background: Contemporary data for the impact of obesity (BMI>30) on the risk of demand ischemia-related myocardial infarction (i.e. type 2; T2MI) and subsequent outcomes is lacking. We aimed to study the risk and outcomes of T2MI with obesity. Methods: We used National Inpatient Sample (2018) to identify adult hospitalizations with T2MI (excluded concurrent T1MI). Multivariable regression was performed to assess the risk of T2MI with obesity. Using propensity-matched analysis obese vs non-obese cohorts (1:1) were obtained to compare comorbidities and primary outcomes (in-hospital mortality/cardiogenic shock). Results: Obese had higher odds of T2MI (OR 1.11, 95%CI:1.05-1.17, p<0.001) when adjusted for confounders. Propensity-matched cohorts ( Table 1 , n=6220 obese & non-obese, each) were comparable for sociodemographics with higher rates of diabetes, hyperlipidemia, COPD, CKD, deficiency anemia, prior history of MI/CABG but lower hypertension, smoking, CHF, PVD, substance abuse, prior stroke than non-obese. Association of obesity did not reach a significant level of difference for all-cause in-hospital mortality (OR 0.93, 95% CI: 0.51-1.70) and cardiogenic shock (OR 1.42, 95%CI 0.75-2.69). Length of stay was similar (3 days) but obese patients with type MI had a higher mean cost of hospitalization. Conclusion: Obesity independently predicted a higher risk of developing T2MI but without any significant association with short-term all-cause in-hospital mortality or cardiogenic shock.