cardiovascular diseases, especially coronary heart disease (CHD), are an epidemic in India. So, early diagnosis of coronary artery disease is necessary. There is an emerging need for the assessment of anatomical variants and anomalies of the coronary artery tree for early diagnosis of coronary artery disease. With rapid advancement of non-invasive imaging like computed tomography coronary angiography, the complex anatomy of the coronary tree is assessed. The most common type of dominant system was the right coronary dominance. The most commonly encountered variant was ramus intermedius branch. In majority, most patients with anomalies are asymptomatic and anomalies were an incidental finding on coronary angiography. Anomalous origin and course of the coronary artery were the commonly encountered of which most are benign; however, few of these anomalies were associated with sudden cardiac death (interarterial course). Other anomalies associated with sudden cardiac death included anomalous origin of the left coronary artery from the pulmonary artery, atresia of the left main stem and coronary fistulae. The aim of this article is to provide an overview of the various normal anatomy, variants, and anomalies with a brief about their clinical presentations.