Coronary artery ectasia (CAE) is an entity common known from 18th century. The advance in imaging methods, especially in coronary angiography, leads to more precise data about incidence of CAE among population, which is stated from 0.2 to 4.9%. Etiology ofCAE is various. CAE can be rarely congenital in origin, can be associated with connective tissue disorders, and also CAE can be a iatrogenic lesion following percutaneous intervention. CAE is often accompanied by coronary artery disease (CAD). We report a case of woman with NSTEMI as a first manifestation of ischemic heart disease, with triple-vessel disease and CAE of LAD and RC, who was managed conservatively with a good effect. We discuss various possibilities of treatment of CAE.