In this study, the immediate and short-term outcome of 9 consecutive patients aged 80 years or older undergoing percutaneous transluminal coronary angioplasty (PTCA) are reported. Of these 9 patients, 8, despite optimal medical therapy, had unstable Class IV anginal symptoms and 6 had multivessel coronary artery disease. Primary success at PTCA (successful dilation of all attempted lesions without any complications) was achieved in 8 of the 9 (89%) patients. The one patient with unsuccessful PTCA had subsequent successful elective coronary bypass graft surgery. The 8 patients with primary success at PTCA have been followed up for a mean of 27 +/- 15 (range: 6 to 45) months. During follow-up, no patient died, required a further revascularization procedure or had a myocardial infarction. Indeed, 7 of these 8 patients have, following PTCA, remained entirely asymptomatic with no decrease in their activity level. Angina has recurred in 1 patient but it is mild and does not restrict his activities. Based on our encouraging experience we suggest that PTCA should be considered favourably in the treatment of selected octogenarian patients with severe angina poorly controlled by medical therapy.