Rarely, essential thrombocythemia has led to coronary artery occlusion. Only one patient has been described, in whom coronary angiography demonstrated multiple coronary thrombosis. We report a case of coronary vasospasm, multiple coronary thrombosis involving right and left coronary artery and possibly leading to myocardial infarction and unstable angina pectoris in a woman with migraine, Raynaud's phenomenon, and essential thrombocytosis.