Background: Acute myocardial infarction (AMI) controlled and promoted by inflammation within the coronary plaque. Monocyte chemoattractant protein-1 (MCP-1) is a pro-inflammatory mediator, that's playing a major role in plaque rupture. This study aimed to assess the diagnostic performance of MCP-1 for early diagnosis of AMI among chest pain (CP) patients. Methods: MCP-1 and cardiac Troponin I (cTnI) were performed for all studied patients. The receiver operating characteristic (ROC) curve was used to assess the diagnostic accuracy of biomarkers. Results: The baseline level of MCP-1 has a good capacity for discriminating patients with AMI from non-coronary chest pain (NCCP), stable angina (SA), and unstable angina (UA) patients with efficiency 91%, 91%, and 83%; respectively. Area under the curves (AUCs) of MCP-1 for diagnosis AMI patients at 0-6 hours and > 6-12 hours after onset time of CP were 0.69 (P < 0.001); and 0.71(P < 0.0001); respectively, compared with cTnI were 0.58 (P < 0.001) and 0.67 (P < 0.001); respectively. However, at > 12-24 hours, cTnI has AUC 0.93 (P < 0.0001) compared with MCP-1 0.74 (P < 0.0001). In conclusion: Independent early baseline MCP-1 has given sufficient diagnostic information for patients with AMI.