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Metabolic Syndrome constitutes the clustering of clinical and biochemical risk factors, which are associated with increased risk of cardiovascular events. NSTEMI accounts for the important part of cardiovascular events with considerable morbidity and mortality. The aim of this study was to investigate the association of metabolic syndrome with angiographic severity of CAD in patients with NSTEMI. This study included a total of 192 prospectively enrolled NSTEMI patients. Statistically significant difference in vessel score was observed between two groups, such as triple vessel disease (TVD) was significantly higher in patients with metabolic syndrome (42.7% versus 15.6%, p<0.001) and single vessel disease (SVD) was significantly higher in patients without metabolic syndrome (45.8% versus 21.9%, p<0.001). The mean total stenosis score of patients with metabolic syndrome was also significantly higher than for those without metabolic syndrome (9.26 ± 4.29 versus 6.06 ± 3.07, P<0.001). The mean extension score of patients with metabolic syndrome was also significantly higher than for those without metabolic syndrome (53.70 ± 18.11 versus 39.11 ± 17.59, P<0.001).