There is no general consensus on the investigation and subsequent management of patients presenting with acute chest pain and elevated cardiac troponin levels, but with non-obstructive coronary arteries on angiography. Recent technological advances in cardiac magnetic resonance imaging have aided in the understanding of the underlying pathophysiology, allowing accurate diagnosis, prognostic information, and guidance for management in these patients. This article reviews the evidence supporting the usefulness of cardiac magnetic resonance imaging in patients with acute chest pain and elevated cardiac troponin levels, but with non-obstructive coronary arteries, and offers insights into the role and future