Introduction: Wellens’ sign is a characteristic finding on ECG, often found to be indicative of severe proximal Left anterior descending artery (LAD) stenosis. Our study sought to identify the prevalence of the Wellens’ sign in the ethnically diverse population of the Bronx, NY and elucidate its relationship to the presence of significant CAD. Methods: We retrospectively analyzed an ECG database at Montefiore Medical Center of over 1.7 million ECGs, using six diagnostic codes for anterior ischemia to identify ECGs that resemble the Wellens’ sign. Of the six diagnostic codes, the ECGs of the two highest yielding codes, were identified, then manually reviewed by an electrophysiologist. Patient’s charts and demographics were reviewed and Chi Square test was used to test statistical significance of the data. Results: Of the 1,756,742 ECGs done on 433,218 patients between 2012-2019, 26,624 ECGs were isolated. Subsequently, 2186 of these ECGs were manually reviewed. Wellens’ sign was identified in 448 (0.1%) patients, of which, 229 patients underwent cardiac catheterization, while 219 patients were managed medically. There was no statistical difference seen in the prevalence of Wellens’ Type A and B pattern across various ethnic groups (P = 0.213). Significant LAD stenosis was seen in 80 (35%) patients of whom 22 (10%) had proximal, 40 (17%) had mid, 4 (1%) had distal stenosis, while 14 (6%) patients had diffuse LAD disease. Two-vessel disease was seen in 46 (20%) of the patients, and triple-vessel disease was seen in 23 (10%) of the patients. Most common indication for cardiac catheterization was NSTEMI. Takotsubo cardiomyopathy was diagnosed in 19 (8%) patients who had either no or non-obstructive CAD. Among patients with the Wellens’ sign on the ECG but did not undergo cardiac catheterization, majority had a non-ACS presentation. Conclusions: No statistical difference in the prevalence of Wellens’ sign was seen among the various ethnic groups. In our study population, Wellens’ sign was a rare ECG pattern with a prevalence of 0.1%. When seen in conjunction with a clinical setting suggestive of angina there is a high probability of underlying CAD. Although significant LAD stenosis is the known most common underlying pathology, multivessel CAD may also occur.