Abstract: Coronary microvascular disease (CMVD) is the clinical syndrome of exertional angina or myocardial ischemia. It is caused by abnormal coronary microvascular structure and/or function that may result from various pathogenic factors. Given the higher incidence of CMVD among patients with coronary heart disease and the poor prognosis of patients with partial CMVD, the early diagnosis, prognostic assessment, and medicaltreatment of CMVDhave critical clinical implications. Quantitative PET/CT analysis can be used toquantify resting and stressed myocardial perfusion values objectively and to obtain coronary flow reserve measurements. Thus, it is an effective approachfor the early diagnosis and prognosis evaluation of CMVD and for guiding therapeutic strategies for this malignancy. In this article, we review the progress in the application of PET/CT blood flow reserve measurement in CMVD.