High levels of pentraxin3 reflect severity of coronary lesions as measured by coronary angiography, very low levels of serum pentraxin 3 could exclude presence of risk for those patients completely so, it is considered agood negative test. We aimed to assess the diagnostic accuracy of C-reactive protein and pentraxin3 in acute coronary syndrome compared with cardiac troponin-1 Methods: A cohort study was conducted on 100 patients and were divided into:NSTE-ACS (NSTEMI and UA) included 70 patients. Non-ACS (SCAD and non-cardiac) included 30 patients. Laboratory investigations were done . Resting 12 leads surface Electrocardiogram (ECG) was done. Echocardiography to assess the left ventricular systolic function was done. By dividing our study populations into 4 groups NSTEMI, UA, SCAD and Non-ACS (non-cardiac),There was highly statistical significant difference regarding hs-CRP, CTnI and PX3. There was statistical significant difference regarding LVEF between group I & III, I & IV, II & III and II & IV. The best cut-off value considering the diagnostic accuracy of PX3 in prediction of acute coronary syndrome is 1.6 with 94.3% sensitivity and 60% specificity, for CTnI is 0.055 with 78.6% sensitivity and 53.3% specificity. Elevated levels of hs-CRP and serum PTX3 in the early hours clearly shows that they can be used as novel markers in the diagnosis of ACS. Their estimation in the early hours of ACS aid in the diagnosis and management of ACS.