OBJECTIVES: To describe current management of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) over 12 months in Greece.   METHODS: Prospective observational study in ACS patients undergoing PCI from September 2008 - April 2009, capturing current practices over 12 months.  RESULTS: Twenty-two sites enrolled 558 eligible patients: 351 patients had unstable angina or non-ST elevation myocardial infarction (UA/NSTEMI) and 207 ST-elevation myocardial infarction (STEMI). Median age was 64 years (IQR 55-73) (UA/NSTEMI) and 56 years (IQR 49-66) (STEMI). Almost all patients (96.4%) received stents: 19% BMS only, 77.5% DES only and 3.5% both. 79% UA/NSTEMI and 86% STEMI patients were  admitted to hospital within 1 day from start of ACS symptoms, while 78% UA/NSTEMI and 89% STEMI patients received the first antiplatelet loading dose (LD) in 1 day. Time from start of ACS symptoms to PCI was ≤3 days in 76% UA/NSTEMI and ≤1 day in 67% STEMI patients. Follow-up data were available for 540 (96.8%) patients. Percentage of patients on antiplatelets and other medications at hospital discharge and 12 months were as follows: aspirin 98%,  97%; clopidogrel 99%, 96%; statins 81%, 79%; beta-blockers 73%, 72%; calcium blockers 11%, 11%; angiotensin II receptor blockers/angiotensin-converting enzyme inhibitors 64%, 62%; proton pump inhibitors 39%, 35%. A formal diet program was followed by 7% patients and a formal exercise program by 6%  through the 1st year of follow up.  CONCLUSIONS: In ACS patients treated with PCI in Greece, dual antiplatelet treatment is maintained in a very high percentage through one year post procedure, and DES use is also high.