Background: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality in the world. Established way of treating patients according to ACC/AHA guidelines is with combination of dual anti platelets (Aspirin and clopidogrel) and anticoagulants. Cardiac benefit of this treatment modality is proven; however, their benefits are matched by a parallel increase in the gastrointestinal (GI) complications including bleeding with a frequency of 7.1%, which has been observed to be a poor prognostic marker, and is one of the most frequent non cardiac complication after PCI. Objectives: To determine the frequency and risk factors of gastrointestinal bleeding in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. Study Design : Observational, prospective cohort study. Duration and place of study. Department of Department of Cardiology, MTI Mardan Medical Complex Mardan, KP – Pakistan from jan 2023 to july 2023 Materials and Methods: The study was initiated after taking approval from hospital ethical committee and an informed written consent was taken from each patient. A sample size of 207 was calculated using the WHO software with confidence interval of 95%, with population prevalence of 71.1% and margin of error as 3.5%. The sampling was done via non-probability consecutive sampling. Basic demographic information including name, age and gender were recorded on a pre-designed performa and time duration of 1.2 hours post symptoms were taken for consideration. After getting consents the patient underwent PPCI followed by observation for gastrointestinal bleeding. After observing the patients who develop GI bleeding up to 72 hours post procedure, its frequency was calculated among the total cases included in the study. Results: Among the Patients selected for this study, 132 were males and 75 were females, with a mean age of 54.1±12.2 years. Out of these patients, those having an inferior wall MI were120 (58%) anterior wall MI were 30 (14.5%), Lateral wall MI were 29 (14%) and Posterior wall MI were 28 (13.5%). GI bleeding after PCI was found in 16 (7.7%) of people. Stratification for age, gender and ACS status was also carried out, showing an incidence of gastrointestinal bleeding in 16 (7.7%) with equal distribution among different age groups, whereas predominantly involving male gender and patients with acute inferior wall MI. Conclusion: In contrast to other studies our study found higher instances of bleeding in STEMI patients, particularly the male population. The chances of major bleeding can therefore be minimized with advancement in procedural methods and pharmaceutical tactics. Keywords: Primary percutaneous coronary intervention; acute myocardial infarction; gastrointestinal bleeding.