Background: Cardiovascular diseases are presently the leading causes of death in industrialized countries and expected to become so in emerging countries by 2020. Among these, coronary artery disease (CAD) is the most prevalent manifestation and is associated with high mortality and morbidity. Objective: The aim of this study was to assess the impact of Type II DM on the left ventricular function measured by 2D Speckle tracking Echocardiography in middle aged patients presenting with NSTEMI who will undergo PCI. Patients and methods: This study was carried on sixty middle aged patients (according to WHO, it should be 55 years of age) admitted with NSTEMI who undergoing (PCI) during their admission at Al-Hussein University Hospital, Mostafa Kamel Military Hospital and the International Cardiac Center (ICC) at Alexandria. They divided into two equal groups (Diabetic group and Non-diabetic control group). Results: The result showed that diabetes had a bigger effect on the initial systolic function but with early intervention.The difference in systolic function in both study groups was insignificant though it was a bit better in non-diabetics. Regarding to the site of significant LAD lesion, statistical difference was found in osteal LAD lesions (more in diabetics) and mid LAD lesions (more in non-diabetics). Conclusion: Early intervention in diabetic patients lessens the effect of CAD on the myocardium even if the disease tends to be stronger than non-diabetics early on. The 2D speckle tracking echocardiography is a promising, feasible, and non-invasive modality to evaluate myocardial deformation.