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Background: The 12-lead ECG is the primary clinical tool for non-invasive assessment of cardiac electrical function. Before any surgery, ECG is commonly used in pre-operative check-up. Therefore pre-operative check-up of large number of people can be a valuable tool for accurate estimates of the prevalence of ECG abnormalities of general population. Objectives: To observe the extent of ECG changes in a group of population undergoing ENT surgery and to describe the prevalence of changes in relation to age and sex. Methods: 704 consecutive adult stable patients were included between age of 20 – 60 years without previously diagnosed case of any other systemic diseases who came to this hospital for elective surgical procedures and were investigated with new ECG for pre-operative check-up in private Hospital between January 201 to December 2010. Results: Total number of ECG recordings were 704; out of them 479 were male & 225 were female. Among 704 ECG recording 486(69.03%) were normal. The number of old myocardial infarction (MI) was in 36 cases (5.11%). Cardiac Ischaemia observed by ST depressions/T inversion was present in 15 cases (2.13%). Conclusion: The observation of the study is concludes that nearly 70% of all asymptomatic people (between 20 – 60 years) possessing normal ECG but Ischaemic changes (like Q wave/ST depression & T inversion/ LBBB) was present in about 8% cases. ECG changes of IHD (Ischaemic Heart Disease) increases with age and male groups at higher risk of developing IHD. Key Words: ECG; Pre-operative Check-up; Myocardial Infarction (MI). DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8630 BSMMU J 2011; 4(2):56-59