PurposeThis study aimed to assess the clinico-demographic profile, risk factors, and pattern of coronary involvement in non-ST elevation acute coronary syndrome (NSTE-ACS) and chronic stable angina (CSA).MethodsThis was a retrospective study conducted in a tertiary care hospital catering mainly to the rural population in Southern India from January 2020 to July 2022. Data from 333 patients with NSTE-ACS and CSA were analyzed during the study period for the clinico-demographic profile, risk factors, and pattern of coronary involvement in angiography.ResultsThe mean age at presentation was 56.05±9.31. Significant obstructive coronary artery disease was present in 234 (70.3%) patients. Overall, single, double, and triple vessel disease occurred in 26%, 20%, and 32.4% of patients with NSTE-ACS and chronic stable angina. Sixty percent of the diabetic and hypertensive patients (n=92/153) had multivessel involvement. Left main coronary artery disease was present in 40 patients (12%).ConclusionUnstable angina was the most common clinical presentation. Left anterior descending (LAD) was the most common coronary vessel to be involved with occurrence of triple vessel disease in 32% of the study population. Multivessel involvement was more common in the diabetic and hypertensive groups.