Abstract: Acute myocardial infarction (AMI) is a severe cardiovascular emergency threatening human health. Percutaneous coronary intervention (PCI) is the primary means to restore myocardial perfusion. However, approximately 2% to 44% of patients experience the "no-reflow/slow-flow" phenomenon postoperatively, adversely affecting prognosis. While a unified and highly effective first-line strategy for coronary no-reflow phenomenon (NRP) prevention and treatment remains elusive, drug therapy— most notably nicorandil, with its multi-targeted mechanism—offers a promising therapeutic strategy. This paper reviews the clinical value of nicorandil in preventing and treating NRP, aiming to provide reference for optimizing clinical treatment regimens.