||Unstable angina (UA) and non ST segment elevation myocardial infarction (NSTEMI) is one of common ischemic sign of acute coronary syndrome (ACS), a serious emergency medical condition and majority of patients admitted with chest pain, affecting citizens at younger ages leading to more death and disability in low- and middle-income countries thereby having a greater economic impact. The study aim was to determine the economic burden of unstable angina in hospitalized patients by analyzing the cost of different health care parameters in public and private hospitals of Karachi. A prospective study was conducted among hospitalized UA/NSTEMI patients from September 2013 to February 2014. Data was analysed and results were obtained with the help of statistical software SPSS version 20.Overall 227 patients of UA/NSTEMI admitted in private and public hospitals. Majority of them were males 66.5% while 33.5% were females presented with chief complaint of chest pain 41.4%. UA found to have 58.1% and NSTEMI 41.9%. Total hospitalization cost has been estimated approximately $ 34485. Factors like accommodation cost, laboratory charges, medicines cost and angiography contributed differently to increase the economic burden as $ 9675 and $ 6002 whereas significant financial load found to be from medicines and angiography $ 6550 and $12247respectively. Despite advances in treatment, unstable angina/ non ST elevation myocardial infarction UA/NSTEMI presents an enormous medical, social, and economic burden on individuals of Karachi.