Abstract: The authors report a case in which cadmium zinc telluride-SPECT radionuclide myocardial perfusion imaging (MPI) combined with coronary flow reserve (CFR) measurement guided clinical decision-making for a patient with recurrent chest pain due to in-stent restenosis after percutaneous coronary intervention (PCI). Through this literature review, the authors deepened clinicians′ understanding of the clinical value of MPI and CFR measurement in the precise diagnosis and treatment decision-making guidance for patients with recurrent chest pain after PCI.