OBJECTIVES: To estimate the costs of atherosclerotic and haemorrhagic events associated with Acute Coronary Syndrome (ACS) treated with ASA + Clopidogrel, in Turkish settings. METHODS: An expert panel was organized to reflect the solid data regarding disease management patterns and options to Turkish payer for reimbursement process. Due to the multidisciplinary nature of the ACS, physicians from the cardiology, neurology and cardiovascular surgery participated to panel. Cost components of bleeding events, haemorrhagic stroke, ischemic stroke, myocardial infarction and revascularization have been identified. Experts have reviewed their daily clinical practices and local & global literature for the related complications along with medical procedures. All cost components including medications, hospitalization, surgical treatments follow up procedures and rehabilitation were considered. For the prices of medications, and diagnostic and therapeutic procedures, March 2014 local prices have been taken into account. For Turkish Lira: Euro conversion, Turkish Central Bank March 2013 currency rate (was used TL/Euro = 3.06). RESULTS: The cost of MI in the first year is 2.004€ and 376€ for the following years. (≈%70) of the cost comes from non-pharmacological treatment. Costs of ischemic and hemorrhagic stroke for the acute period and following three months are 2.266 € and 3.010€, respectively. Annual cost of ischemic and haemorrhagic strokes are 2.951€ and 3.646€ for the first year. The main cost drivers for stroke are also non-pharmacological treatments, mainly physiotherapy for stroke. (≈%70-80 for the 1^st year) Coronary revascularization costs 833€ for percutaneous interventionand 2.354€ for coronary by-pass. Bleeding costs are relatively low compared to other complications. Major and minor bleedings are 189€/event and 17€/event. CONCLUSIONS: Costs of the ACS related complications are quite high. Especially acute phase of MI and stroke has significant burden of the budget. More effective secondary prevention of the ACS might reduce the burden of disease in the Turkish settings.