We describe a case of patient with severe angina pectoris unresponsive to medical therapy who was treated with spinal cord stimulation. The patient was studied by dynamic positron emission tomography (PET) (13-N ammonia) and with heart rate variability. Spinal cord stimulation was effective in reducing anginal attacks and PET documented an enhancement of myocardial perfusion when spinal stimulator was activated. Heart rate variability did not change during spinal cord stimulation.