Background: Acute coronary syndrome (ACS) is a life-threatening condition resulting from reduced blood flow to the myocardium, which can lead to ischemia and infarction. Biomarkers such as brain natriuretic peptide (BNP) and troponin I (Trop I) play key roles in the diagnosis and prognosis of ACS. Investigating the correlation between these biomarkers and clinical outcomes may enhance risk stratification. Objectives: To determine the correlation between BNP and troponin I levels in ACS patients and assess their relationship with clinical outcomes such as left ventricular (LV) dysfunction, arrhythmias, and mortality. Methods: A prospective observational study was conducted on 75 patients diagnosed with ACS at a tertiary care hospital. BNP and troponin I levels were measured on days 1 and 3 of hospitalization, and clinical outcomes were documented during the hospital stay and after 1 month. The main outcomes included reinfarction, cardiogenic shock, ventricular arrhythmias, and mortality. Results: Of the 75 patients, 58.67% were male, with a mean age of 59.25 years (±11.15). Major risk factors were hypertension (54.67%), diabetes mellitus (49.33%), and dyslipidemia (13.33%). Patients with BNP levels >600 pg/mL had a significantly higher incidence of complications (90.9%) compared to those with lower BNP levels. Similarly, 91.66% of patients with troponin I >20000 ng/L developed complications such as LV dysfunction and arrhythmias. Conclusion: Elevated BNP and troponin I levels are significantly correlated with adverse clinical outcomes in ACS patients. BNP and troponin I can serve as valuable prognostic markers for identifying high-risk patients