Background Depression poses a major health challenge to patients with cardiovascular disease. But little is known about its impact on Non-ST-elevation myocardial infarction (NSTEMI). Methods Using the data from the 2016 National Inpatient Sample database, we identified hospitalization with a principal diagnosis of NSTEMI with or without medical history of depression. Prevalence and baseline characteristic of NSTEMI patient with or without depression was delineated. Mortality, catheterization rate, length of stay, time to catheterization were compared using multivariate linear regression with adjustment for age, sex, race, region, hospital size, Charlson Comorbidity Index, tobacco, heart failure, diabetes, and stable coronary heart disease. Results Depression was found in 42,914 (9.11%) of total NSTEMI admission of 470,933. A higher percentage of female and a higher prevalence of hypertension, hyperlipidemia, diabetes, and smoking (table 1) was observed in the depression group. No significant association between depression and in-hospital mortality in NSTEMI patient can be found after adjustment for confounders (odds ratio 0.88, p=0.08). However, having depression was associated with lower catheterization rate (odds ratio 0.91, p<0.001), prolonged time to catheterization (1.4 vs 1.2 days, p=0.029) as well as prolonged length of hospital stay (4.9 vs 4.0 days, p<0.001) in admissions because of NSTEMI. Conclusion Depression is associated with decreased catheterization rate, increased length of stay and delayed catheterization in NSTEMI patient. Further investigation of the impact of depression on NSTEMI patient is warranted.