Aim: Coronary artery disease (CAD) is one of the most frequent causes of mortality and morbidity worldwide. Coronary angiography is the gold standard for the anatomical diagnosis of coronary artery stenosis. Myocardial Perfusion Scintigraphy (MPS) is a non-invasive imaging modality used for the diagnosis of CAD. In this study, we aimed to compare the findings of MPS and coronary angiogram.Method and Methods: Eighty-one patients (37 males, 44 females; mean age 55 ± 10.95 years) with angina and detected perfusion defects on MPS were included in this study. All of the patients underwent coronary angiogram. A narrowing ≥ 50% was considered pathological on the coronary angiography.Results: Findings of the coronary angiogram and MPS were compared and found consistent in 51 (63%) patients. A coronary narrowing < 50% was detected by coronary angiogram in 4 (5%) of the remaining patients. Coronary angiogram was found to be normal in the remaining 26 patients (32%) and these patients were evaluated as cardiac syndrome X (CSX) known as microvascular angina (MA).Conclusion: The findings showed that MPS is superior to coronary angiogram in the early diagnosis of myocardial perfusion disorders at the microvascular level. Therefore, we concluded that MPS should be the primary diagnostic tool to begin treatment before an anatomically large narrowing occurs in the coronaries.