From 1988 to 1995, approximately 10,000 patients with coronary artery disease have been treated using excimer laser angioplasty. All data underline the feasibility and safety of this technique. However, coronary excimer laser angioplasty has been performed as a stand-alone procedure in a minority of patients, only, either due to an insufficient angiographic result, or due to complications such as abrupt vessel closure, severe dissection or perforation. Clinical and angiographic follow-up studies have also documented that excimer laser angioplasty does not reduce the incidence of restenosis following the coronary intervention. Experimental results underline the importance of pressure waves and bubble formations, which can cause additional vessel wall trauma despite thermal injury. Promising new laser devices should offer high ablation rates with only minimal thermal and acoustic tissue injury. It is expected that such laser devices will emit in the mid-infrared spectrum of light.