This chapter, written for undergraduate medical students and post-graduate doctors in training, presents information on how to manage chest pain — a case which they are likely to encounter in the future in a general practice setting. It presents the case of a 48-year-old shopkeeper who pain in the chest, which has been coming and going for about 6 months. He feels it in the front of the chest, on the left side and is able to pinpoint it with his finger. The chapter provides details of the patients' medical history and the key findings of clinical examination, together with initial investigation results data for evaluation, and helps them develop their skills of clinical reasoning. Key questions then prompt the student to evaluate the patient, and reach a decision regarding their condition and the possible treatment plan.