Refractory angina is a common, growing problem in cardiology due to the effective treatment of coronary disease, which improves prognosis. Significant progress has been confirmed in the current guidelines on the management of stable angina pectoris. The article discusses the present value of haemodynamic treatment and new directions of pharmacotherapy, i.e. bradycardic and metabolic agents. High-risk patients, i.e. diabetic and elderly patients, are also considered. Invasive procedures in refractory angina for no-option patients are briefly presented. Their implementation in common practice is still controversial and requires further investigations.