Background: Acute coronary syndrome (ACS) can be divided into subgroups of ST-segment elevation myocardial infarction (STEMI), non ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. ACS carries significant morbidity and mortality and the prompt diagnosis, and appropriate treatment is essential. Objective: To compare the immediate and short-term outcome of two different complete coronary revascularization strategies in patients with NSTEMI and multivessel coronary artery disease. Patients and Methods: 100 Patients with multivessel CAD and NSTE-ACS that underwent percutaneous coronary intervention were included, during the period from December 2017 to December 2019. They were divided into two equal groups according to revascularization strategy; Group I: had been subjected to complete coronary revascularization during the index procedure (1S- PCI group), and Group II: had been subjected to multistage PCI complete coronary revascularization during the index hospitalization (MS- PCI group). In order to characterize a coronary lesion as culprit on angiography, at least two morphological features suggestive of acute plaque rupture should be present: intraluminal filling defects consistent with thrombus, plaque ulceration, plaque irregularity, dissection or impaired flow. All patients had at least 2 vessels with 50% stenosis, and the angiographic severity of CAD was assessed using the Syntax Angiographic Score. Results: The occurrence of the primary endpoint was significantly higher in group II (MS-PCI) where there are six cases of cardiac deaths reported. The same results were recorded regarding occurrence of malignant arrhythmias. On the other hand, there were 6 cases of reported CI-AKI with transient rise of serum creatinine managed conservatively without need of renal replacement therapy (2 cases in group I and 4 in group II). Finally, there were 12% of patients had minor bleeding (4% in group I versus 20% in group II with significant statistical difference). Conclusion: In NSTEMI patients with multivessel disease, total revascularization during the index procedure was superior to multi-staged PCI complete coronary revascularization during the index hospitalization in terms of MACCE.