Ischemic heart disease (IHD) incidence has increased in India. Ayurveda, a 3000-year-old Indian traditional medicine system along with allopathic medicine can provide a solution to improve myocardial perfusion in stable IHD patients. This pilot study involves ischemia reversal programme (IRP), an Ayurvedic treatment modality to aid IHD patients using SPECT-myocardial perfusion imaging (SPECT-MPI) for assessment of myocardial perfusion in IHD patients. The present open-label study involved fourteen IHD patients who underwent IRP (21 sittings in total, administered twice per week) in Madhavbaug clinics along with their standard care therapy. The inclusion criteria were patients with known IHD, age = 40-70 years, BMI > 20 kg/m2, and stress test positive for inducible ischemia. SPECT-MPI was performed at enrolment and post-IRP (12-week follow-up) from December 2016 to September 2017. VO2max and time to onset of ischemia after stress test were also recorded. Seattle angina questionnaire (SAQ) was telephonically completed by research coordinators. Observations from SPECT-MPI test showed a significant difference in summed stress score (13.5 ± 10.3, baseline vs. 10.7 ± 10.1, post-IRP; P = 0.01) as well as summed difference score (8.9 ± 6.2, baseline vs. 6.2 ± 6.3, post- IRP; P = 0.03) compared from baseline to post-IRP sittings. And we also observed the increase in VO2max levels (12.8 ± 5.7 to 19.4 ± 7.8) and the time to onset of ischemia (370.7 ± 201.1 to 597.8 ± 201.9) was observed. SAQ scores showed significant improvement post-IRP (30.2 ± 3.6 to 32.7± 3.5). Findings of this study suggest an improvement in myocardial perfusion post-IRP in IHD patients and depict the positive role of IRP as an add-on to standard care therapy in IHD management.