Abstract: Good microcirculation perfusion is an essential premise for myocardial viability of chronic totally occluded lesions. Delicate blood flow autoregulation is the guarantee for microcirculation perfusion. It is crucial for clinicians to have a clear understanding of autoregulation and changes of microcirculation functions of chronic totally occluded lesions. This article reviews the clinical research related to microcirculation of chronic totally occluded lesions.