Acute coronary syndrome (ACS) refers to the spectrum of acute coronary artery diseases spanning acute myocardial infarction (AMI) and unstable angina (UA). They are sudden, severe and life-threatening events. This report reviews the current algorithm for monitoring the incidence of ACS in Australia, presenting a detailed analysis of hospitalisations for AMI and UA. It also presents a range of alternative algorithms for the estimation of ACS incidence. Further work is required to validate these algorithms.