Background: Type D (distressed) personality is characterized by a combination of negative affectivity and social inhibition. There are divergent results on the association between Type D personality and cardiovascular events. We aimed to assess the association between Type D personality and in-hospital major adverse cardiovascular event (MACE) in Turkish patients presenting with acute coronary syndrome. Methods: One hundred consecutive patients admitted to a coronary care unit with the diagnosis of acute coronary syndrome were included in the study. Type D personality was evaluated with the Turkish version of the 14-item Type D Scale. Results: Seventy eight patients were male, the mean age of subjects were 61.7 +/- 11.9 years old. The prevalence of type D personality was 45%. Presence of MACE was independently associated with type D personality (OR: 10.817, 95% CI: 1.765-66.301, P = 0.01), presence of STEMI (OR: 7.860, 95% CI: 1.588-38.900, P = 0.012) and low LVEF (OR: 7.842, 95% CI: 1.557-39.501, P = 0.013). Conclusion: Type D personality is an independent risk factor for MACE in acute coronary syndrome patients.