Background: Individual risk stratification should influence the scheduling of invasive coronary angiography and revascularization in NSTE-ACS patients; the importance of risk scores as prognostic evaluation tools in NSTE-ACS patients is obvious. Aim of the work: To investigate the hypothesis that layer specific speckle tracking echocardiography (LS-STE) can be a useful risk stratifying tool in NSTE-ACS. Subjects and methods: All patients were given a thorough medical history, a thorough clinical examination, a 12-lead ECG, and a high-sensitivity troponin T test (hs-TnT). On admission, the TIMI risk score for UA/NSTMI was assessed and all patients suspected of NSTE-ACS underwent transthoracic echocardiography, which included 2-dimensional speckle tracking echocardiography (2D-STE). The LS-STE and GLS (global longitudinal strain) were determined. The SYNTAX Score (Synergy Between PCI with Taxus and Cardiac Surgery) was estimated. Results: There was a positive correlation between longitudinal strain endomyocardiam (LSEN) with both TIMI score and SYNTAX score, Patients were divided into two groups based on their syntax scores: group I with SYNTAX score more than or equal one and group II with SYNTAX score zero. The mean LVEF was higher in group II while the mean GLS and the mean LSEN were higher in group I, and both the mean MAX. hs-TnT/24hrs and the percentage of patients with positive hs-TnT were higher in group I. Conclusion: In NSTE-ACS patients, LS-STE and GLS might be employed as a risk stratification tool.