Introduction: Coronary artery disease (CAD) is considered a major causative agent of mortality and morbidity. Many reports recommended the use of C-reactive protein (CRP) as an inflammatory marker for its high sensitivity that could help in prevention of CAD. Objective: This work aimed to clarify the in-hospital prognostic value of high-sensitivity CRP (hs-CRP) in ST-elevation myocardial infarction (STEMI) cases who are treated by thrombolysis vs. primary percutaneous coronary intervention (PCI) and comparing the outcome of the treatment between the two groups. Patients and methods: 48 STEMI cases were divided into two groups in this cross-section study: Patients in group A had Primary PCI, whereas those in group B received thrombolysis treatment. Patients were evaluated by history, examinations, investigations and coronary angiography. Results: Most of patients had grade II mitral regurge (68.8%) with statistical insignificant differences between the study groups. Most of patients had wall motion abnormalities in anterior septum (43.8%) with statistical insignificant difference between groups. In this study, 41.7% of patients had positive troponin with statistical insignificant difference between groups. According to distribution of patients as regards outcomes, died patient and patients with heart failure had significantly higher median of first- and second-hour CRP than patients without adverse events Conclusion: Impaired reperfusion was correlated with higher hs-CRP compared to optimal reperfusion. This study was conducted on CRP so further investigation with larger population size are necessary especially for inflammatory cascade.