Background: Acute Myocardial Infarction (AMI) is a leading cause of death globally, requiring rapid and accurate diagnosis to ensure timely treatment. The Cardiac Troponin-T (TROP-T) test has emerged as a highly sensitive and specific biomarker for detecting AMI, often used alongside CK-MB and LDH assays. However, variability in the diagnostic performance of these tests, especially in the early hours post-symptom onset, necessitates further evaluation of their clinical utility. Aim: This study aimed to assess the diagnostic efficiency of the TROP-T test in comparison to CK-MB and LDH assays in patients admitted with suspected AMI to the Intensive Cardiac Care Unit (ICCU) at Tripura Medica, Agartala. Methods: A prospective observational study was conducted involving 120 patients who presented with symptoms of AMI. Diagnosis was based on clinical history, ECG findings, and biomarker levels. The TROP-T test was performed immediately upon admission and repeated in selective cases with early (0-4 hours) negative or faintly positive results. CK-MB and LDH assays were also performed. Data were analyzed using SPSS version 23.0 to determine the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each test. Results: The TROP-T test demonstrated a sensitivity of 96.8% and specificity of 84.0%, outperforming CK-MB (92.6% sensitivity, 80.0% specificity) and LDH (89.5% sensitivity, 76.0% specificity). Repeating the TROP-T test in cases with initial ambiguous results improved diagnostic accuracy. Statistical analysis confirmed the TROP-T test's superior diagnostic performance in early AMI detection. Conclusion: The TROP-T test proved to be a highly sensitive and specific biomarker for diagnosing AMI, particularly in the early hours following symptom onset. Its performance was superior to CK-MB and LDH assays, suggesting that it should be the preferred initial diagnostic tool in the ICCU setting. Recommendations: Based on the findings, it is recommended that the TROP-T test be used as the primary diagnostic tool for AMI in the early stages of chest pain presentation. Repeated testing is advised in cases with initially ambiguous results to improve diagnostic accuracy.