The result of the development of research in cardiology revealed the opportunity to implement the concept of the “golden hour” to restore coronary blood flow, which formed a new attitude to myocardial infarction with the recognition of its emergency, treatment of which requires emergency hospitalization. In recent years, a sufficient number of multicenter studies have been conducted, the data of which provided an opportunity to formulate the main strategic directions of care for patients with acute coronary syndrome and became the basis for the development of clinical guidelines by leading national and international organizations. The aim of our research was to conduct a comparative analysis of modern approaches to the treatment of acute coronary syndrome in Ukraine and abroad. The research used logical, graphical methods and the method of system analysis. The article covers modern issues of classification of acute coronary syndrome, methods of its diagnosis and treatment. Based on the results of clinical studies, global trends in the diagnosis and treatment of acute coronary syndrome are shown. The article also discusses the organization of medical care, and in particular the possibilities and problems of reperfusion therapy in the treatment of acute coronary syndrome. Analysis of literature sources and own data indicate the existence of some problems in the treatment of acute coronary syndrome, among which significant factors in high mortality are late treatment and late hospitalization. Organizational measures to improve patient awareness, early diagnosis, and early reperfusion treatment are important steps in improving the prognosis of acute coronary syndrome.