Spontaneous coronary artery dissection is an easily ignored cause of ischemic heart disease. The long term prognosis and optimal treatment is not clear. Two patients with spontaneous dissection of the right coronary artery complained of intermittent chest tightness. There was no history of trauma, catheterization, and associated aortic disease. They were treated with medical therapy and stent respectively according to the severity of clinical manifestation. Fourteen-month angiographic results of medical treatment and clinical status of stenting are good. The results of these different treatments are both effective.