Background: Ischemia preconditioning (IPC) ameliorates coronary no-reflow induced by ischemia/reperfusion (I/R) injury, and pericytes play an important role in microvascular function. However, it is unclear whether IPC exerts a protective effect on coronary microcirculation and regulates the pericytes.& nbsp;Objective: The purpose of this study was to assess whether IPC improves coronary microvascular perfusion and reduces pericyte constriction after myocardial I/R injury. Methods: Rats were randomly divided into three groups: the sham group, the I/R group, and the IPC + I/R group. The left anterior descending artery (LAD) of rats in the I/R group were ligated for 45 min, and the rats in the IPC + I/R group received 4 episodes of 6 min occlusion followed by 6 min reperfusion before the LAD was ligated. After 24 h of reperfusion, the area of no-reflow, and area at risk were evaluated with thioflavin-S and Evens blue staining, and infarct size with triphenyl tetrazolium chloride staining, respectively. Besides, fluorescent micro spheres were perfused to enable visualization of the non-obstructed coronary vessels. Cardiac pericytes and microvascular were observed by immunofluorescence, and the diameter of microvascular at the site of the pericyte somata was analyzed. Results: The infarct size, and area of no-reflow in the IPC + I/R group were significantly reduced compared with the I/R group (infarct size, 33.5% +/- 11.9% vs. 49.2% +/- 9.4%, p = 0.021;no-reflow, 12.7% +/- 5.2% vs. 26.6% +/- 5.0%, p < 0.001). IPC improved microvascular perfusion and reduced the percentage of the blocked coronary capillary. Moreover, we found that cardiac pericytes were widely distributed around the microvascular in various regions of the heart, and expressed the contractile protein alpha-smooth muscle actin. The microvascular lumen diameter at pericyte somata was reduced after I/R (4.3 +/- 1.0 mu m vs. 6.5 +/- 1.2 mu m, p < 0.001), which was relieved in IPC + I/R group compared with the I/R group (5.2 +/- 1.0 mu m vs. 4.3 +/- 1.0 mu m, p < 0.001). Besides, IPC could reduce the proportion of apoptotic pericytes compared to the I/R group (22.1% +/- 8.4% vs. 38.5% +/- 7.5%, p < 0.001). Conclusion: IPC reduced no-reflow and inhibited the contraction of microvascular pericytes induced by cardiac I/ R injury, suggesting that IPC might play a protective role by regulating the pericyte function.