Background: Globally cardiovascular diseases are a number one cause of death. Acuterncoronary syndrome accounts most cardiovascular deaths which is a life threateningrncondition requires a lifesaving intervention and intensive nursing practice. Acute carernnurses play an integral role in the assessment and care of patients with ACS. However wernknow little about the knowledge and practice of nurses regarding care of ACS. rnObjective: The aim of this study was to assess knowledge, practice and associated factorsrnregarding care of acute coronary syndrome among acute care nurse working at selectedrnhospitals of Addis Ababa, Ethiopia 2021.rnMethods: Institution based cross-sectional study was conducted from February 8 to Marchrn8 among 265 nurses working in ICU, CCU and Emergency departments recruited fromrnselected governmental hospitals by census method. The data was collected by selfadministeredrnrnquestionnaires and entered in to Epi info then transferred to SPSS forrnanalysis. Descriptive statistics were calculated and also binary logistic regression and multirnvariable logistic regression were used to determine association. rnResult: The study revealed that from a total of 265 nurses with a response rate of 95% werernparticipated in this study from which (52%) of the respondents had good knowledge andrn(56.4%) had good practice regarding care of acute coronary syndrome. There was arnsignificant association between nursesâ€™ knowledge level and training (AOR=9.2, 95%CIrn(3.4-25.29), P value=0.000) and availability of guidelines (AOR= 7.2, 95%CI (1.5-34.4),rnP value=0.000). Training (AOR= 9.7 95% CI (3.33-28.5) P value= .000 and working unitrn(AOR=6.4, 95% CI=1.46-28.4, P=0.014) were also significantly associated with nurseâ€™srnpractice towards ACS care. rnConclusion and recommendations: The results from this study showed that nurses hadrninadequate knowledge and practice towards ACS care. Lack of guide lines and training arerna contributing factors. Therefore, the hospitalâ€™s administrative and supportivernorganizations would better to provide training regarding care of ACS and avail guidelines.