Abstract: Objective　To explore the association of serum adipocytokines levels with the severity of non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods　A total of 137 inpatients with non-ST-segment elevation acute myocardial infarction and unstable angina pectoris (NSTE-ACS group) were enrolled in this study. Seventy-nine inpatients underwent coronary angiography (CAG) but without coronary artery stenosis during the same period (Non-CAD group) were also included. Serum levels of adipocytokines pentraxin3 (PTX-3), plasminogen activator inhibitor-1 (PAI-1), galectin-3 (GAL-3), netrin-1 (NTN1), interleukin-37 (IL-37) and adiponectin (ADP) were detected by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was used to analyze the predictive value of pro-inflammatory cytokines and anti-inflammatory cytokines. The relationship between coronary atherosclerosis index (CAI) score and adipocytokines was assessed. The difference of serum adipocytokines levels in patients with the different number of stenotic coronary arteries was also compared. Results　The serum levels of pro-inflammatory adipocytokines PTX-3, PAI-1 and GAL-3 were significantly higher in NSTE-ACS group than those in Non-CAD group, while the serum levels of anti-inflammatory adipocytokines NTN1, IL-37 and ADP were significantly lower in NSTE-ACS group than those in Non-CAD group (all P＜0.01). The PTX-3 (rs=0.594), PAI-1 (rs=0.452), GAL-3 (rs=0.682) were positively correlated with CAI scores. The NTN1 (rs=-0.312), IL-37 (rs=-0.650) and ADP (rs=-0.582) were negatively correlated with CAI scores (all P＜0.05). The AUC of PTX-3, PAI-1, GAL-3, NTN1, IL-37 and ADP to predict NSTE-ACS were 0.913, 0.701, 0.837, 0.776, 0.905 and 0.857, respectively, and the best diagnostic cutoff values were 2.95 μg/L, 724.5 ng/L, 2.66 μg/L, 58.6 ng/L, 103 ng/L and 9.1 μg/L respectively. In the NSTE-ACS group, the serum levels of PTX-3, PAI-1 and GAL-3 were increased with the increased numbers of stenotic coronary arteries, but the NTN1, IL-37 and ADP levels were decreased (all P＜0.01). Conclusion　Serum pro-inflammatory adipocytokines including PTX-3, PAI-1 and GAL-3 are positively correlated with the severity of NSTE-ACS, while the anti-inflammatory adipocytokines, NTN1, IL-37 and ADP are negatively correlated with the severity of NSTE-ACS. All the above adipocytokines can be used as biomarkers for the clinical diagnosis and the severity assessment of NSTE-ACS.