Introduction: Patients who are transferred between acute care medical facilities are an overlooked population. In this study, we explore the in-hospital outcomes of patients with a non-ST segment elevation myocardial infarction (NSTEMI) who were transferred to an acute care hospital from another acute care center. Methods: We queried the National Inpatient Sample database (2016-2019) to identify patients admitted with a principal diagnosis of NSTEMI. We conducted propensity score matching using a greedy nearest neighbor 1:1 model. Multivariable logistic regression was used to compare mortality. Results: 131,948 patients met our inclusion criteria. Patients with a NSTEMI who were transferred from an acute care center had 1.20 times higher odds of suffering in-hospital mortality compared to regular hospital admissions (aOR 1.20, 95% CI: 1.13-1.28; p < 0.001). When separated by race, acute care transfers had a higher mortality rate amongst White patients (3.5% vs 3.1%, p < 0.001), but a decreased mortality rate in Black patients (3.5% vs 3.6%, p = 0.008, Figure 1). Acute care transfers were more likely to undergo percutaneous coronary intervention (35.9% vs 34.0%, p < 0.001) and have intraoperative cardiac arrest (0.04% vs 0.01%, p < 0.001, Table 1). Conclusions: Patients who were transferred to acute care hospitals from other acute care centers with a NSTEMI had higher odds of suffering in-hospital mortality compared to regular hospital admissions. Acute care transfers with a NSTEMI require additional medical support in the inpatient setting. Further studies should explore potential interventions to address these differences in outcomes.