Background: The apolipoprotein B (ApoB) is the main component of very low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), low-density lipoproteins (LDL) and lipoprotein(a) (Lp(a)) particles. LDL contains variable quantities of cholesterol, but each lipoprotein contains a single ApoB protein, while Apolipoprotein A1 (ApoA1) is the main apolipoprotein incorporated into high‐density lipoprotein (HDL). It has a major role in reversing cholesterol flow and cellular cholesterol homeostasis once detected. Therefore, the ApoB/ApoA1 ratio reflects the cholesterol balance between atherogenic and anti-atherogenic lipoprotein particles. Aim: The aim of the study is to measure ApoB/ApoA1 ratio in patients with acute myocardial infarction. Methods: Total of 60 patients aged 18–80 years were included in the study. The plasma levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1, ApoB protein, ApoB/ApoA1 ratio were determined after a 12 h fasting period. Results: Mean ApoB/ApoA1 ratio for our study was 0.87 with 60% of STEMI patients had ratio >0.8. In our study, 23.64% of patients had absolutely normal lipid profile with deranged ApoB/ApoA1 ratio. Conclusion: Despite normolipidemic, the subjects with the unfavourable ApoB/ApoA1 ratio had more atherogenic lipid profile and corelated its relationship with the severity of CAD.