Coronary physiology has revolutionized the evaluation and management of ischemic heart disease by bridging anatomical findings with functional outcomes. Techniques like fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) have become essential in assessing coronary stenosis and guiding percutaneous coronary intervention (PCI). The advent of coronary CT angiography-derived FFR further enhances non-invasive diagnostic precision and treatment planning. This Research Topic explores the expanding role of coronary physiology beyond stenosis evaluation, focusing on its utility in characterizing coronary artery disease (CAD) patterns and addressing microvascular dysfunction. We accept all article types on its application in multivessel stable CAD and its influence on treatment strategies post-acute coronary syndrome. Emphasizing the prognostic and therapeutic insights derived from physiological indices, we aim to deepen the understanding of diffuse versus focal CAD and their clinical implications. Additionally, this topic will address challenges faced by patients with angina and non-obstructive coronary arteries (ANOCA), highlighting coronary physiology's role in understanding microvascular resistance and endothelial dysfunction. We welcome contributions on a range of subjects, including: o Innovative physiological indices and their applications in CAD characterization. o Insights into CAD progression and its clinical implications. o The role of coronary physiology in diagnosing and managing microvascular dysfunction. o Integration with imaging modalities for enhanced CAD assessment. By fostering interdisciplinary collaboration and showcasing novel advancements, this Research Topic aims to refine our understanding and application of coronary physiology in contemporary cardiology.