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Objective: To compare the coronary artery disease pattern in patients with and without diabetes presenting with Non-ST-Elevation Myocardial Infarction (NSTEMI). Study Design: Retrospective, Hospital Based, Observational Comparative study. Setting: Punjab Institute of Cardiology, Lahore. Period: January 2022 to December 2022. Material & Methods: 180 Non-ST-Elevation Myocardial Infarction (NSTEMI) patients who were separated into two groups on the basis of Diabetes mellitus being absent or present and each group comprised of 90 individuals. All data was analyzed, and comparison was made among the two study groups. Results: Hypertension and smoking status was found to have significant differences among the two study groups. Significant number of individuals in the diabetic group were found to be smokers (46.6 % vs. 31.1 %; p = 0.03). The commonest risk factor in the diabetic group was noted to be hypertension. Single vessel disease was found to be significantly higher in the non-diabetic group in comparison with the diabetic group (25.5% vs 11.1%; p = 0.01) whereas diabetics showed significantly higher number of multivessel disease individuals. Coronary artery disease was more severe in the patients with Diabetes mellitus and grade was significantly higher along with LM being affected at a significantly greater rate in diabetic patients. Conclusion: Non-ST-Elevation Myocardial Infarction (NSTEMI) patients presented with Diabetes are more likely to have extensive and more severe coronary artery disease than the non-diabetic individuals. [ABSTRACT FROM AUTHOR]