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Abstract Objective To investigate a new risk score for acute chest pain with suspected non‐ST‐segment elevation acute coronary syndrome (NSTE‐ACS). Methods Patients who suffered from Chest pain and suspected NSTE‐ACS were enrolled as subjects. Predictor variables had been analyzed, and a bootstrap technique was used to evaluate the internal validity of the model, and external validation had been assessed for a prospective cohort study. Results Thousand five hundred and sixty‐eight patients had been included in this study. Six predictor variables were found to be significant and were used to develop the model. The C‐statistic of the model was 0.83, and internal validation revealed the stability of the model and the absence of over‐optimism. Patients were given different triage recommendations, and the risk score was prospectively validated. Conclusions A risk score may be a suitable method for assessing the risk of major adverse cardiac events and aiding patient triage in emergency departments among patients with suspected NSTE‐ACS.