Refractory angina is a disabling condition that afflicts patients in whom we have no more strategy to improve their quality of life. This phenomenon has been increasing over the last years due to longer life expectancy, also resulting in a significant impact upon healthcare resources. The coronary sinus Reducer is a novel technology designed to improve the quality of life of these patients. The aim of this paper is to provide an overview of the available data regarding this new technology, along with the experience of the three centers that have performed the highest number of implants in Italy, focusing our attention on the clinical presentation of these complex patients and their follow-up.