In patients suffering acute coronary syndrome, antiplatelet agents are one of the mainstays in treating and preventing lethal consequences, with or without ST-segment elevation. Large evolving trials currently are comparing the new antiplatelet P2Y12 inhibitors to the reference clopidogrel. The focus of this literature review is to analyze the standard antiplatelet to P2Y12 in patients enduring acute coronary syndrome with or without ST-segment acclivity. We searched in the PubMed database for relative articles using the following Mesh words "P2Y12 inhibitors", "Prasugrel," "clopidogrel," "Ticagrelor," and "acute coronary syndrome." Most of the available trials concluded that P2Y12 inhibitors are superior to clopidogrel in preventing acute coronary syndrome complications, such as death or stroke. In addition, P2Y12 inhibitors were not found to have more risk of major bleeding complications compared to clopidogrel. In regards to which P2Y12 inhibitors are more effective and safe to use, either ticagrelor or prasugrel, this remains an area of debate. Further clinical trials and meta-analyses are recommended to answer this question.