Introduction: Elderly patients were more likely to have non Q wave MI. The key issue for the elderly is that only few patients have symptoms and ECG findings that qualify them for thrombolytic therapy. This may be because of a reduced incidence of sudden plaque rupture or because of extensive collateral protection against transmural infarction.Cardiovascular complications including cardiogenic shock, atrial fibrillation and heart failure were common in elderly patients. Methodology:In this study 100 cases of acute myocardial infarction patients admitted in ICCU of above hospital studied during the period of 2013 to 2015. The cases are followed up upto the hospital stay 100 cases are divided into 2 groups, Group –I Elderly (60 years of age)-50 patients and Group – II Younger patients–( 60 years of age)-50 patients. Results: Elderly patients were predominantly presented with breathlessness 50% V/s 16%, giddiness 24% V/s 10%,syncope 10% V/s 2%,palpitations 16% V/s 6%,altered sensorium and pain abdomen when compared to younger patients. Conclusion:Although chest pain was the commonest presenting symptom in both age groups 60% of elderly group presented with atypical chest pain compared to 24% in younger group.Elderly patients were presented more atypicaly with the symptoms like breathlessness, giddiness, syncope, altered sensorium and pain abdomen with breathlessness being the predominant atypical symptom.