Myocardial infarction with non-obstructive coronary artery (MINOCA) is a common acute coronary syndrome in clinical practice. Its diagnosis is more difficult than general acute coronary syndrome, and may be difficult to distinguish from other non ischemic diseases that can cause similar symptoms and myocardial damage. Delayed treatment timing can have a significant detrimental effect on patients. This article provides a review of the clinical diagnosis and treatment progress of MINOCA, with the aim of providing guidance for clinical practice.