Background: Chest pain at rest is one of the most frequent symptoms of patients in the emergency room. The diagnosis of acute coronary syndrome (ACS) is suspected in these patients, especially when typical electrocardiographic (ECG) changes and/or elevation of cardiac markers can be detected. However, of all patients who undergo coronary angiography because of suspected ACS, up to 30% have unobstructed coronary arteries or at least no culprit lesion that could explain the patient’s discomfort. Objectives: Aim of this Study is to determine the prevalence of normal or near normal coronary arteries among population subjected to coronary angiography specifically among patients with acute coronary syndrome. Methods: We evaluated coronary angiographies of 259 patients who were admitted to the catherisation laboratory between August 2011 to January 2012 with the diagnosis of acute coronary syndrome (ACS) either ST elevation (STEMI) or non-ST elevation acute myocardial infarction (NSTEMI) or unstable angina (UA) with the intention of determining the prevalence of normal or near normal coronary angiographs. Results: Our study showed the prevalence of normal or near normal coronary angiograms to be 14.7% (38 patients) of the 259 admitted patients presenting with acute coronary syndrome. We compared the prevalence of normal or near normal angiograms in both patients presenting with ST elevation myocardial infarction and those presenting with Non ST elevation ACS .We found no patients presenting with STEMI who had normal coronary angiograms. We found only 2 patients presenting with NSTEMI with normal coronary angiography. Stratification of all ACS patients admitted according to the commonly known risk factors (Diabetes mellitus, hypertension, dyslipidemia, smoking and positive family history of coronary artery disease). It was found that the most frequent risk factor was Hypertension (52.12%), D.M. (50.97 %), smoking (46.72%), Dyslipidemia (35.14%) and lastly positive family history of CAD in (13.9%) of ACS patient admissions. Conclusions: 38 patients (14.7%) out of all 259 ACS studied patients were found to have normal or near normal coronary angiograms. There were no patients suffering from STEMI with normal or near normal coronary angiograms. It was found that the most frequent risk factor was hypertension, D.M. , smoking , Dyslipidemia and lastly positive family history of CAD in of ACS patient admissions. Patients suffering from ACS with normal or near normal coronaries were found to be predominantly male, relatively younger in age and had less prevalence of the common risk factors known for CAD.