We aimed to evaluate longitudinal trends of racial and ethnic disparities in the utilization of diagnostic angiograms, percutaneous coronary intervention (PCI), and coronary artery bypass graft surgery (CABG) for non-ST elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI). We retrospectively analyzed the National Inpatient Sample (2005-2019). The fifteen-year period was divided into five, three-year periods. Our study included 9 million adult patients (NSTEMI, 72%; STEMI, 28%). No improvement in utilization of these procedures was seen in period 5 (2017-2019) vs. period 1 (2005-2007) for both NSTEMI and STEMI in non-White patients vs. White patients (P>.05 for all comparisons), excepting in CABG for STEMI in Black patients vs. White patients (difference in CABG rate: period 1, 2.6%; period 5, 1.4%; P=.03). Reducing disparities in PCI for NSTEMI and both PCI and CABG for STEMI in Black patients vs. White patients was associated with improved outcomes.