Introduction: Non–ST-elevation myocardial infarction (NSTEMI) is a critical cardiac emergency often presenting with severe chest pain. In the Emergency Department (ED), timely assessment and relief of pain are essential to limit myocardial ischemia and reduce anxiety. Nurses play a central role in identifying symptoms, initiating early interventions, and coordinating multidisciplinary care. Methods: A narrative review of literature from 2018–2024 and clinical observation in emergency and cardiac care units were performed to describe nursing strategies for pain control in NSTEMI. The analysis was structured through NANDA-I, NOC, and NIC frameworks, focusing on comprehensive pain assessment, medication management, vital signs monitoring, and emotional support across care settings. Results: Early and structured pain assessment in the ED—using standardized scales and continuous monitoring—allowed rapid recognition of ischemic pain and prompt pharmacological intervention (oxygen therapy, nitrates, morphine as prescribed). Nursing collaboration with physicians reduced treatment delays and improved hemodynamic stability. Patients receiving consistent analgesic and supportive care reported lower pain intensity and higher comfort scores. Transition to inpatient care maintained benefits through continuity of nursing monitoring and communication. Discussion: Effective nursing management of pain in NSTEMI begins at ED triage and continues throughout hospitalization. The integration of evidence-based protocols, early recognition, and empathetic communication not only relieves pain but may also positively influence myocardial outcomes. Developing shared guidelines and continuous nursing education enhances safety and quality in acute cardiac care. Keywords: NSTEMI, pain management, emergency nursing, cardiac care, nursing interventions, patient-centered care.