This study aims to look at the incidence of myocardial injury after elective percutaneous coronary intervention (PCI) and to correlate its effect to midterm clinical outcome. Methods: A total of 182 patients were enrolled. Their mean age was (57.44 ± 9.15) years. They were undergoing elective PCIs in Azadi heart center, Duhok, Iraq. Cases with positive cardiac troponin (cTn) pre-procedural were excluded. Within first 24-hours after PCI (cTn) was estimated. And then after all patients were followed for 12 months for major adverse cardiac events (MACE). Results: 36 (19.8%) out of 182 (100%) had elevated cTn. Those patients with elevated cTn had a statistically significant higher rate of prior CABG, ECG changes, triple vessels disease, type C lesions, post stent balloon dilatation and more periprocedural side branch jeopardy and coronary dissections compared to those with negative cTn (P ≤ 0.05). During follow up; the MACE was higher in patients with positive cTn (log rank = 0.04). Conclusion:Minor myocardial injury after elective PCI is common. It's associated with procedural complexity and stratified patients at risks of worse prognosis.