Abstract Inspite of guidelines recommendations about reduction of lipid profile parameters to decrease recurrent cardiovascular events and improving outcome. Decision to choose which drug to achieve target levels is still under study .so our study aiming to assess safety and efficacy of Rosuvastatin 40mg and Atrovastatin 80mg in patients with acute coronary syndrome. . Methods: one hundred patients divided into two equal groups randomized for two drugs and followed up at 1 month and 3 months from the date of admission. and Routine lab tests on admission including (LFT,KFT,CBC,coagulation profile,lipid profile). Follow up after one month of admission including anti-inflammatory markers(ESR,hs-CRP,TLC). follow up after three months of admission including lipid profile(LDL-C,HDL-C,TC,TG),echo parameters and clinical outcome. . Results: at baseline there was no significant difference in age, gender, risk factors, lipid profile and inflammatory markers between 2 groups p>0.05. After 3 months HDL increased from 38.7±13.3to 45.6±13.3vs 36.4±9.5 to 35.3±9.4 in groups A and B respectively, P