Background: Cardiac troponin is a structural protein within the cardiac myocytes and is a highly sensitive and specific marker to diagnose cardiac cells injury and damage. Objective: This study aimed to detect the effect of troponin level assessed on admission on the angiographic and clinical outcome post primary PCI. Patients and Methods: We conducted a cohort study to assess the prognostic relation between rise of first troponin on presentation and primary PCI success and post-primary PCI clinical outcome either during the hospital stay or during the follow up period after discharge. This study was conducted on forty-four patients presented to the Emergency Department with STEMI and underwent primary PCI. Results: The TIMI flow grade post PCI was (I) in 5 patients (11.4%), (II) in 7 patients (15.9%) and (III) in 32 patients (72.7%). For the 32 patients who had TIMI III flow, we went for further analysis of reperfusion by assessing the myocardial blush by evaluating the TMPG. It was found that 3 patients (9.4%) had TMPG (I), 4 patients (12.5%) had TMPG (II) and 25 patients (78.1%) had TMPG (III). No patients were recorded to have major flow limiting dissection that ended with complications or coronary perforation. The in-hospital outcome was assessed and the total number of patients who had complications during hospitalization was 12 patients (27.3%). Conclusions: This study findings support that a single measurement of hs-cTnT provides significant incremental information to risk stratification after STEMI.