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Background: Cardiac arrhythmias are quite common in the setting of acute myocardial infarction. Ninety percent of patients with acute myocardial infarction (AMI) have some cardiac rhythm abnormality, and 25% have cardiac conduction disturbance within 24 hours of infarct onset. These are tachyarrhythmias, ventricular arrhythmias, and atrioventricular block. A good correlation exists between the site of infarct and type of arrhythmias. Sinus bradycardia, sinoatrial escape rhythms, Wenkebach type and complete heart block are usually associated with inferior wall myocardial infarction (IWMI). Atrial premature contraction (APC) and ventricular premature contraction (VPC) are usually seen in anterior wall myocardial infarction (AWMI). Methods: The present cross-sectional study was conducted on 100 consecutive cases of acute myocardial infarction with arrhythmias attending as indoor emergency patients of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar were included. History, clinical examination and required investigations including lipid profile, blood sugars, electrolytes, CPK-MB, ECG, and 2D-Echo were done. Results: Out of the hundred patients in the study, males (57%) outnumbered females (43%). Most of the patients were found in the age group of 51-60 years (34%). Smoking was the most significant risk factor (38%), followed by diabetes mellitus (35%), hypertension (30%) and prior ischemic heart disease (28%). The majority (56%) of the patients had anterior wall myocardial infarction (AWMI), followed by IWMI (24%), IWMI + RVMI (13%) and AWMI + IWMI (7%). Most of the arrhythmias (62%) developed during initial 24 hours of admission, while 27% in next 24 hours and 11% after 48 hours of admission to hospital. The most common arrhythmia observed was VPC (50%), followed by sinus tachycardia (48%), sinus bradycardia (16%), accelerated idioventricular rhythm (9%), 3rd degree heart block (7%), ventricular tachycardia (6%), 1st degree Heart Block (5%), 2nd degree Heart block (5%), ventricular fibrillation (4%), APC (4%) and AF (1%). Maximum incidence of VPC, sinus tachycardia, ventricular tachycardia (VT) and ventricular fibrillation (VF) were recorded in AWMI, while the maximum incidence of sinus bradycardia and AV block were observed in IWMI. Mortality was more common in patients developing arrhythmias specifically VT, VF and heart blocks especially 2nd-degree heart block and 3rd-degree heart block. Conclusion: Most of the patients with acute myocardial infarction develop some kind of arrhythmias which is an important cause of morbidity in these patients, develop during the initial 24 hours of admission to the hospital. Most common arrhythmias observed were VPC, followed by sinus tachycardia, AV block, bundle branch block, sinus bradycardia, VT, and VF. VPC, sinus tachycardia, VT, and VF were more common in AWMI, while sinus bradycardia and AV block were more common in IWMI. Diligent monitoring for arrhythmias and appropriate treatment can be life saving.