In developing countries like India where limited resources available in the field of health care services we can utilize our clinical skills and ECG impressions for prognostication purpose and further managing the patients in the better way. The purpose of the study is to study the various clinical presentation in patients with unstable angina, NSTEMI. Study carried out in 100 patients with unstable angina and NSTEMI. We find statistical significant correlation between wall of myocardium affected with final outcome (p=0.0002). However complication rate was highest in group with multiple ST-T changes (global). No complications were seen in patients with ECG changes in Lateral wall. Commonest outcome we encountered in complicated outcome cases was acute myocardial infarction, a total of 6 patients. We observed 5 patients with of arrhythmia (3 patients of supra-ventricular tachycardia and 2 patients with non-sustained ventricular tachycardia). A total of 3 patients succumbed to death during hospital stay. We also found 2 patients each develop CHF/LVF and recurrent angina. Between TIMI risk score and final outcome we did not find significant correlation