OBJECTIVES: Acute coronary syndrome (ACS) is a major complication of the atherosclerotic process that may lead to myocardial necrosis. It is a medical emergency and requires immediate hospital admission. The aim of the present study was to assess the epidemiology and economic burden of ACS in Turkey, where the population is aging, incidence of cardiovascular diseases tend to increase, yet, knowledge on ACS-related health expenditures are inconclusive. METHODS: For this purpose, the 2008 data acquired from 28 hospitals of the Diagnose-Related Group Project were evaluated, accounting for 6.5% of the population. Accordingly, the number of hospitalized patients with an ACS diagnosis in 2008 was 102,677. The majority of patients with ACS were ≥40 years of age, and thus, all statistical analyses were limited to this age group. RESULTS: The rate of new ACS admissions was calculated as 444 per 100,000. With the assumption (based on earlier published work) that 1/3 of ACS patients failed to reach health care settings, the prevalence of new ACS cases in the general population was estimated to be 666 per 100,000. The average in-patient fatality rate was 29% (41% for females and 24% for males) among the ≥40 years of age group. The economic burden of ACS in Turkey was 1,778,372,874 USD. The direct cost was 151,261,411 USD, whereas the indirect cost was 1,364,742,497 USD. The cost due to the loss of public tax was 262,368,964 USD. Medication costs, which are annually 590 USD per patient on average, encountered a small percentage of total expenditures, compared with that of hospital services and the loss of public tax. CONCLUSIONS: To prevent ACS, health policies targeting risk factors should be emphasized in an effort to improve efficacy and efficiency of cost.