Background: Compliance with self-care or lifestyle modification is recommended for all patients with the diagnosis of acute coronary syndrome (ACS) for secondary prevention. Information is limited about the association between the level of self-care and restenosis in follow-up patients with ACS. Purposes: This study was conducted to examine the predicting factors on low compliance with self-care and to identify whether low compliance with self-care affected the restenosis among the patients who were followed up. Sample and Methods: A total of 166 ACS patients (M=64.2 years, SD=10.8) who were hospitalized to take an angiogram for follow-up or symptom management were recruited and individually interviewed at a cardiovascular care unit from a university hospital from January to July, 2010. A 20-itemed self-administered questionnaire was used to evaluate the level of compliance with self-care regarding regular clinic visit, medication, diet, activity/rest, sexual life, and stress management. In addition, 6-itemed questionnaire was used to assess the level of symptom-related satisfaction with daily living. Electronic medical records were reviewed to identify clinical characteristics. The total score of self-care was not normally distributed and then it was regarded < 60 points in total score as a low compliance with self-care. Data were analyzed by using SPSS PC version 14.0.. Results: In-stent restenosis was found among the 40.4% of the patients who underwent angiogram. Of the patients, 35.1% were currently smoking. There was no significant relationship between low compliance with self-care and restensosis in this study. Multivariate logistic regression analysis showed that smoking continuers were 11 times more likely than those who were quitters or non-smokers to have low compliance with self-care (OR, 11.410: 95% CI, 4.192-31.184). Patients who had lower symptom-related satisfaction with daily living and had a period less than 1 year since first diagnosis were 5 times (OR, 4.952: 95% CI, 1.911-19.047) and 4 times (OR, 3.796: 95% CI, 1.394-10.340) more likely than those who had higher satisfaction with daily living and had longer period than 1 year to have low compliance, respectively. Conclusions: These findings suggest that the patients who continued to smoke and had lower satisfaction with daily living had a stronger tendency to lower compliance with self-care and lifestyle modification. Effective educational strategies are needed to increase compliance with self-care for patients with ACS, especially while admitted with a first heart attack.