A large proportion of patients with angina and evidence of myocardial ischemia do not have obstructive coronary disease. One of the main mechanisms of ischemia/angina with non-obstructive coronary arteries is coronary microvascular dysfunction, which is rarely diagnosed in clinical practice and patients continue to experience symptoms and have a reduced quality of life. The current review discusses the advantages, limitations, and clinical application of the fluoroscopic methods for assessment of microvascular dysfunction.