Background: Early identification of myocardial infarction in chest pain patients is crucial to identify patients at risk and to maintain a fast treatment initiation. The aim of the study is to test whether determination of high sensitive cardiac troponin T (hs-cTnT) has facilitated the early diagnostic assessment of chest pain patients. Methods: We measured the levels of hs-cTnT in 200 chest pain patients, and compared these results with those of a contemporary troponin I assay and 20 healthy persons for comparison. A clinical evaluation followed by ECG, serial measurement on admission and after 3 and 6 hrs was done. Results: Non-ST segment elevation myocardial infarction (non-STEMI) was diagnosed in 115 (57%) patients. Hs-cTnT had a greater diagnostic accuracy regarding non-ST segment elevation myocardial infarction. Among those patients, 86% were hs-cTnT positive and 73% were cTnI positive on admission (P <0.01). Hs-cTnT yielded a higher sensitivity and negative predictive value (NPV), whereas cTnI had a higher specificity and positive predictive value (PPV). Conclusion: Hs-cTnT provides an excellent early diagnostic accuracy regarding non-ST segment elevation myocardial infarction. Therefore, should be implemented as a standard test in clinical routine which allows earlier and improved decision making and facilitates discharge from the emergency department. Keywords: Chest pain, acute coronary syndromes, acute myocardial infarction, troponin