Introduction: Heart disease is the leading cause of hospitalization and death in elderly patients. The elderly with acute myocardial infarction (AMI) have been reported to present with more atypical symptoms such as acute confusion, syncope, atypical chest pain, vomiting, and weakness. The role of conventional cardiovascular risk factors in older persons is incompletely understood because only fragmentary and inadequate data are available in most instances. Methodology: Data of 50 pts of elderly pts and 50 pts of younger patients who fulfilled the inclusion and exclusion criteria were collected. Their clinical profile including History, risk factors, past illness detailed physical examination, investigation findings, and the complications these patients developed in the hospital was recorded in the pretested proforma and the results were analyzed and the differences were compared Results: 64% of elderly patients had complications but in younger patients, only 32% had one or the other complications. 6% V/s 10% patients among elderly patients having LVF, 12% V/s 10% cardiogenic shock in elderly, 20% V/s 8% patients had arrhythmias in elderly group compared to younger patients. 68% of younger patients had no complications. Conclusion: The incidence of major complications like cardiogenic shock, and arrhythmias were significantly higher in elderly AMI patients (12%, 20%) compared to (10%, 8%) respectively in younger patients.