To examine the clinical efficacy of percutaneous transluminal coronary angioplasty in elderly patients, 350 consecutive procedures of coronary angioplasty were reviewed by dividing the patients into two groups: 142 cases of elderly patients whose ages were 65 years or older and 208 cases of younger patients. The primary success rate was satisfactory in both groups (86.6% in the elderly patients and 88.5% in the younger patients) and frequency of complication was acceptable (3.1% vs 2.9%) in both groups. Although restenosis tended to occur more frequently in the elderly patients (36.8% vs 27.1%), most of the lesions were re-dilated. These indicate that coronary angioplasty can be extended to elderly patients. The primary success rate started to decrease with circumflex arteries at age 70 years, and a similar trend was seen with right coronary arteries at age 65 years. Careful selection of the patients for coronary angioplasty as well as detailed analysis of the coronary anatomy and aorta are required to obtain clinical success and to prevent complications.