Objective : Primary PCI (PPCI) is the preferred reperfusion strategy STEMI patients. Coronary no-reflow (NR) is characterized by inadequate myocardial perfusion without angiographic evidence of mechanical obstruction. NR significantly lead to increased mortality and LV dysfunction. The objective of the review is to provide a comprehensive overview of the pathogenesis, predictors, diagnosis, and management of NR. Design: Data were reviewed from various scientific databases including primary and secondary sources to contribute various phenomenon of NR.