Prognosis of patients with Microvascular angina is not as benign as is considered despite normal coronaries. It contributes to increased suffering, health care costs and may have role in long term increased cardiovascular risk. There is increasing consensus about underlying coronary microvasculature abnormality with or without other risk factors. A lot more research and clinical work is required to develope effective and optimum treatment to alleviate the symptoms and improve microvascular function. In this review we have discussed the prevalence, pathophysiology and available investigative and treatment modalities and present limitations and need of further studies and research about coronary microvascular dysfunction.