Chronic coronary syndrome is a common cause of chest pain. Ischaemia with non-obstructive coronary arteries (INOCA) is underdiagnosed and more frequent in women. Patients with INOCA have a lower quality of life and a higher risk of major adverse cardiac events. Symptoms arise from endothelial dysfunction, microvascular disease, vasospastic disease or a combination. Invasive functional testing is important to secure the diagnosis and endotype of the patient. This review finds that the treatment is both pharmacological and non-pharmacological and is guided by endotype of INOCA and has shown improved quality of life.