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The main features of functional anato­my, physiology, pathophysiology and coronary angiography are presented and the clinical importance of coronary artery collaterals in pa­tients with ischemic heart disease is discussed. Coronary artery collaterals can provide perfu­sion of the regions compromised by the signif­icantly narrowed or occluded coronary arteries. The collaterals appear to reduce the extent and the degree of myocardial ischemia, as well as the size of myocardial infarction. The presence of collaterals occasionally can even prevent the development of myocardial infarction.