Background: Acute arterial vascular events are the leading cause of premature death and disability in the developed world. The present study was conducted to assess homocysteine as a risk factor in patients with acute vascular events. Materials & Methods: 74 patients of ischemic heart disease,peripheral vascular disease, deep vein thrombosis and pulmonary thromboembolism of both genders underwent estimation of fasting plasma homocysteine estimation was done by fluorescence polarization immunoassay. Symptoms and risk factors such as hypertension, smoking, alcohol, diabetes, BMI and family history was recorded. Results: Out of 74 patients, males were 40 and females were 34. Symptoms such as chest pain was seen in 62, headache in 57, breathlessnessin 52 and palpitations in 40. Risk factors were hypertensionin 34, diabetesin 30, alcohol in 16, smoking in 23, dyslipidaemia in 65 and family h/o CADin 40. The difference was significant (P< 0.05).