To study the prescribing patterns of thrombolytics in Acute Myocardial infraction and their outcome in Tertiary care hospital. A prospective observational study was carried out in the Coronary care unit (CCU) (medicine in-patient department) of Rajah Muthaiah Medical College and hospital. A total of 100 patients were enrolled for the study to investigate the prescribing patterns of thrombolytics using a predesigned format out of which 100 of them completed successfully. Where door to needle time have a significant role in determining the efficacy of thrombolytics. Majority of subjects affected in our study were elderly male age group of 61-70 years followed by age group 51-60 years females suffered from acute myocardial infraction. It was also found that male patients (72%) suffered more than the female patients.