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Objectives: To determine the frequency of undiagnosed diabetes mellitus (DM) in patients of acute myocardial infarction (AMI) presented in a tertiary care hospital. Study Design: Descriptive observational study. Setting: Cardiac Center at Hail Region, Saudi Arabia. Period: October-2016 to September-2017. Methods: One hundred (100) patients of acute STelevation myocardial infarction (STEMI and Non-STEMI) presented. Fasting blood sugar (FBS) levels more than 126 mg/dl on two consecutive samples was diagnosed as diabetes mellitus. Patients taking anti-diabetic medications were diagnosed as known cases of diabetes. All the patients records were entered in SPSS v17 for analysis. Prevalence of newly diagnosed and known diabetic patients were presented as frequency and percentage. Results: Mean age of acute MI patients was 51.65+8.23 years. There were 82% male and only 18% female patients with male/female ratio of 4.5/1. There were 74% patients who presented with acute STEMI and remaining 26% patients presented with non-STEMI. Hypertension was present in 43% patients and smoking in 36% patients. There were 32% patients who were previously having diabetes mellitus and diabetes was diagnosed for the first time in 12% patients. Remaining 56% patients were free from diabetes. Conclusion: Prevalence of undiagnosed DM is very common in patients of AMI. Immediate diagnosis should be done in acute MI patients without previous history of DM. [ABSTRACT FROM AUTHOR]