Abstract :We report a 54-year-old Kuwaiti male presented as inferior wall ST elevation myocardial infarction (STEMI). Patient was loaded with Clopidogrel 600mg by the first medical contact. After primary percutaneous intervention patient was loaded with Ticagrelor 180 mg with intravenous (IV) glycoprotein IIb/IIIa inhibitor infusion for 24 hours. Patient has several episodes of stent throbosis during the consecutive days. As a result of this complications it was decided to switch Ticagrelor to Pasugrel and was loaded with 60mg of Pasugrel. On Pasugrel also patient had stent thrombosis and hence heart team was activated and decided to go for emergency coronary artery bypass graft surgery. This case report emphasizes the Ticagrelor and Pasugrel related stent thrombosis and management.