Wellens syndrome is a pre-infarct stage of coronary syndrome and a clinical condition associated with left descending proximal anterior artery stenosis. Diagnostic criteria for Wellens syndrome include clinical history, ECG changes, and laboratory results. The pathognomonic ECG of Wellens syndrome is anterior inverted T-wave in precordial leads, which can be seen during pain-free period, accompanied by isoelectric or minimally elevated ST segment (<1 mm), no precordial Q waves, and normal or slightly elevated cardiac serum markers. Early diagnosis leads to early management and a better prognosis. Early management of Wellens syndrome involves maintaining an airway, breathing, circulation, monitoring vital signs, and medical management. Still, the only definitive management is urgent cardiac angiography to prevent further myocardial ischemia. The combination of early diagnostic and appropriate management will reduce complications and mortality rates. Keywords: Wellens Syndrome, Acute Coronary Syndromes, pre-Infarct MI.