Background: Cine cardiac MRI sequences require repeated breath-holds, which can be difficult in patients with ischemic heart disease (IHD). Objective: To compare a free-breathing accelerated cine sequence using deep-learning (DL) reconstruction and a standard breath-hold cine sequence in terms of image quality and left-ventricular (LV) measurements in patients with IHD undergoing cardiac MRI. Methods: This prospective study included patients undergoing 1.5-T or 3-T cardiac MRI for evaluation of IHD between March 15, 2023, and June 21, 2023. Examinations included an investigational free-breathing cine short-axis sequence with DL reconstruction (cine-DL). Two radiologists (R1, R2), in blinded fashion, independently assessed LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), and subjective image quality, for cine-DL sequence and standard breath-hold balanced SSFP sequences; R1 assessed artifacts. Results: The analysis included 26 patients (mean age, 64.3±11.7 years; 14 men, 12 women). Acquisition was shorter for cine-DL than standard sequence (0.6±0.1 min vs 2.4±0.6 min, p<.001). Cine-DL, in comparison with standard, showed no significant difference for LVEF for R1 (51.7±14.3% vs 51.3±14.7%, p=.56) or R2 (53.4±14.9% vs 52.8±14.6%, p=.53); significantly greater LVEDV for R2 (171.9±51.9 vs 160.6±49.4 ml, p=.01) but not R1 (171.8±53.7 vs 165.5±52.4 ml, p=.16); and no significant difference in LVESV for R1 (88.1±49.3 vs 86.0±50.5 ml, p=.45) or R2 (85.2±48.1 vs 81.3±48.2 ml, p=.10). Mean bias between cine-DL and standard was: LVEF, 0.4% for R1 and 0.7% for R2; LVEDV, 6.3 ml for R1 and 11.3 ml for R2; LVESV, 2.1 ml for R1 and 3.9 ml for R2. Subjective image quality was better for cine-DL than standard for R1 (2.3±0.5 vs 1.9±0.8, p=.02) and R2 (2.2±0.4 vs 1.9±0.7; p=.02). R1 reported no significant difference between cine-DL and standard for off-resonance (3.8% vs 23.1%, p=.10), and parallel-imaging (3.8% vs 19.2%, p=.19) artifacts; blurring artifacts were more frequent for cine-DL than standard (42.3% vs 7.7%; p=.008). Conclusion: Free-breathing cine-DL sequence, in comparison with standard breath-hold cine sequence, showed very small bias for LVEF measurements and better subjective quality. Cine-DL yielded greater LV volumes. Clinical Impact: Free-breathing cine-DL may yield reliable LVEF measurements in patients with IHD unable to repeatedly breath-hold.