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NSTEMI can be defined as angina pectoris and elevated creatine kinase enzyme (CK-MB), and troponin T or I, with at least Pain, occurring at rest and usually lasting >20 minutes (if not interrupted by nitroglycerin administration) or being severe and described as frank pain, and of new onset (i.e., within 1 month) or occurring with a crescendo pattern (i.e., more severe, prolonged, or frequent than previously. The risk of new-onset Atrial fibrillation(AF) is highest during the first 2 months after the acute MI (16% event rate).The Purpose of the current study to determine the frequency of high neutrophil to lymphocyte ratio and its common clinical outcome among patients with non ST elevation myocardial infarction at Cardiology Unit, Lady Reading Hospital, Peshawar from 17. 2021 to August 16, 2021.The current study result show that 250 patients with non ST elevation myocardial infarction were observed, in which Male to female ratio was 1.45:1. The study included age ranged from 30 up to 71 years. Average age was 53.14 years ± 11.39SD. High neutrophil to lymphocyte ratio (HNLR) was found in 74 (29.60%). From the recent study we conclude that High neutrophil to lymphocyte ratio was observed and compared to other national and international studies. Male were found in majority than females.