Aim To analysis of patients with non-ST elevation acute coronary syndrome in 2008,and scale the gap between real world pratice and evidence-based guidelines.Methods Clinical data of the dianosis and management of 373 patients with non-ST elevation acute coronary syndrome from January to December in 2006,and scale the gap between real world pratice and evidence-based guidelines.Results Elevated cardiac markers,chest X-ray,echocardiography,dynamic electrocardiogram,exercise electrocardiograph (ECG),coronary angiography were used more extensively,but the usage of cardiac stress imaging and electron-beam computed tomography was low.Significant increases in the use of coronary angiography,aspirin,using 300 mg first dosage of aspirin,β-blocker,angiotensin converting enzyme inhibitor (ACEI),thienopyridine,statins and invasive strategies such as percutaneous coronary intervention (PCI) (51.1%),early invasive intervention occurred.The utilization rate of morphine sulfate,nitrates,unfractionated heparin were low.Conclusions There are great progress in the dianosis and management of patients with non-ST elevation acute coronary syndrome.Still,further improvements are needed for optimal implementation of these guidelines such as the use of β-blocker,adding dosage of β-blocker,platelet glycoprotein Ⅱb/Ⅲa inhibitor,low-molecular-weight heparin.Prompt and effective measures should be taken to enhance the education of evidence-based guidelines.