Background: As Coronary Computed Tomography Angiography (CCTA) becomes more widely used as the standard of care for patients with acute chest discomfort, health care practitioners will see more coronary artery abnormalities and variants. Although the majority of coronary artery anomalies and variants are not clinically significant, some can cause myocardial ischemia due to the anomalous artery's flow-limiting effects. It's critical to distinguish between clinically significant coronary artery variants that may necessitate intervention and incidental coronary artery variants that represent little to no risk to the patient. The interprofessional team will learn about the occurrence, imaging, hemodynamic importance, and treatment of congenital coronary artery abnormalities in this exercise. Conclusion: Review the incidence of coronary artery anomalies, describe the features of hemodynamically significant coronary artery anomalies, determine which coronary artery anomalies require treatment, and summarise the accepted imaging techniques for evaluating coronary artery anomalies are the goals of this review article.