Background: Coronary microvascular disease (CMD) affects the structure and function of the coronary microcirculation, presents highly in patients with cardiovascular risk factors, and is often associated with adverse effects. Objective: The aim of the study was to assess the opinion of Saudi cardiologists on CMD, its management in clinical practice, and the need for comprehensive guidelines for the management of the condition. Methods: We adopted a cross-sectional study through self-administered questionnaire survey among cardiologists in Middle and Eastern Saudi Arabia. A formal questionnaire was developed and distributed to the participants of the study in the morning just before they could start their daily activities. The respondents were recruited through convenience sampling method. Our survey was divided into three sections: demographics, clinical practice, and opinion of cardiologists on diagnosis, prognosis and CMD as a disease entity. Results: Demographic results indicated that 62% of the respondents were cardiologists in practice while 38% of the respondents were cardiologist in training, 47% of the respondents were female while 53% were male. Practice setting comprised of 67% of respondents from academic hospital and 33% from non-academic hospital. Equally, 47% of the respondents had sub-specialized in cardiology while 53% did not have specialization in cardiology. The most applied treatment in this case was lifestyle intervention (23%), nitrates (22%) and calcium channel blockers (22%) were equally used by the cardiologists. The findings show that 42.6% and 31.5% of the male and female respondents believe that coronary microvascular disease exists as a separate-entity. Of the participants, 48.1% of the female respondents and 42.6% of the male respondents believe coronary microvascular disease do not exist as separate-entity (p=0.435). These findings are consistent with previous studies that have indicated that significant differences do not exist on the perception of CMD among the various gender groups of cardiologists.