Despite diagnostic and therapeutic advances, the rate of event recurrence is still relatively high and short- and long-term prediction of risk is necessary although extremely challenging to provide optimal treatment to patients with acute coronary syndromes. Available data recommend the use of C-reactive protein (CRP) as a prognostic marker in patients with acute coronary syndromes in addition to other prognostic factors including troponin levels. Evaluation of CRP levels at time of admission should be included in the evaluation of the patient's risk profile, including clinical data, associated diseases, markers of myocardial necrosis (especially troponin levels), left ventricle performance, and age. A cutoff level of 10 mg/L for CRP may be used as a marker of higher risk for death and possibly myocardial infarction in acute coronary syndromes, and a cutoff of 3 mg/L identifies a group of patients with intermediate risk and a high rate of recurrent events.