Congenital myocardial ischemia is treated with interventional or coronary artery bypass grafting, valve replacement, radiofrequency ablation, or open heart surgery. Congenital coronary artery dysplasia can lead to myocardial ischemia. Coronary angiography is needed to clarify the stenosis, which can be treated with coronary intervention and stent implantation. If stenting is not possible, coronary artery bypass grafting can be performed. Congenital aortic valve severe stenosis, can cause myocardial ischemia, need to be treated with aortic valve replacement. Hypertrophic obstructive cardiomyopathy is a congenital heart disease caused by genetic predisposition. Severe hypertrophic septal obstruction will lead to myocardial ischemia. It can be treated with radiofrequency ablation with anhydrous alcohol or open heart resection of the hypertrophied septum. For congenital myocardial ischemia, it is necessary to go to the hospital for a complete examination to clarify the cause, and then follow the doctor’s advice to actively treat the disease.