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Introduction: The incidence of Coronary Artery Disease (CAD) in young is rapidly growing in number and it carries a significant health-economic weight to the community. Since it is more frequently seen in South Asia, it is essential to understand the patients’ profile in our community aiming for a better preventive strategy. Objectives: The objective of the study was to evaluate the clinical and coronary angiographic characteristics of young patients with Myocardial Infarctions who were presented to Cardiology Unit, Teaching Hospital Kandy. Method: A descriptive cross sectional study was conducted at Cardiology Unit Kandy from 2015 September to 2017 September. All patients aged 45 years or less, having the history of angina, definite ECG changes and positive troponin values consistent with myocardial infarction were enrolled. Patients’ demographic characteristics, risk factor profile, laboratory tests results and coronary angiography patterns were evaluated. Results: A total of 212 patients (83.49% males) with a mean age of 39.54±6.48 years were reviewed. Dyslipidemia, diabetes mellitus and hypertension was seen in 34.91%, 16.98% and 22.64% respectively. There were 46.7% of smokers and among them, the mean exposure was 5.57±4.48 pack years. There were only 21.23% patients who had engaged in recreation related physical activity and among them 48.89% (only 10.38% of the total patients) had a recreation related physical activity level up to World Health Organization recommended activity standard. There were 2.36%, 61.32%, 16.98% and 19.34% with a body mass index of underweight, normal range, overweight and obese respectively. In the angiographic analysis, normal coronary arteries were found in 8.01% of patients. Significant atherosclerotic coronary lesions mainly found in the left anterior descending artery, which was 55.18% (n=117) followed by 34.90% (n=74) in the right coronary artery and 19.81% (n=42) in the left circumflex artery. There were 14.15% (n=30) had Chronic Total Occlusions (CTOs), 3.77% (n=8) with coronary artery ectasia and 2.83% (n=6) with coronary slow flow syndrome. There were 39.62% (n=84) had Single Vessel Disease (SVD), and the majority of SVD, the left anterior descending artery was the commonest (73.80%, n=62) territory involved. Conclusion: Smoking, lack of exercise, obesity and dyslipidemia are the main risk factors observed among young patients with MIs. Interestingly, there is a nearly half of the patients had multi-vessel disease. This reflects that adjustment and promotion of healthy life style should be the primary goal in prevention of young myocardial infarction.