Type 2 myocardial infarction is the ischemic necrosis of cardiomyocytes due to oxygen supply/demand imbalance. The most common causes are surgery, sepsis, arrhythmias, hypo/hypertension. Patients with type 2 myocardial infarction, a disease that accounts for about 25% of total myocardial infarctions, have more comorbidities and are older than patients with type 1 myocardial infarction. Coronary angiography is not mandatory, but it may be useful for the differential diagnosis with acute coronary syndrome. The prognosis in these patients is severe and burdened by high non-cardiovascular and cardiovascular mortality. Treatment is poorly codified and involves the management of trigger events and/or treatment of the underlying coronary artery disease, which is often present; revascularization has an uncertain benefit. Ongoing studies will provide insight on this complex disease.