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The association of acute coronary syndrome with any immunological mediated polyradiculopathy like Guillain–Barré syndrome is very rare. We report such a rare association of acute myocardial infarction and Guillain–Barré syndrome. Our patient underwent primary angioplasty successfully, but developed respiratory failure while in hospital. While the difficulty in weaning off from ventilator a suspicion of neuromuscular disease was made. The further investigations, including nerve conduction study confirmed a diagnosis of Guillain–Barré syndrome. Despite treatment, the patient died secondary to multi-organ dysfunction. Our case is 4th reported in the literature without use of any thrombolytic agent for such association.