The authors report a retrospective study about 20 cases of left main coronary disease admitted during 7 years. The mean age is 60 years with a large predilection for men (65% cases). The left main coronary stenosis generally presented as instable angina in 45% cases, myocardial infarct in 40% cases and left ventricular dysfunction in 10% cases. The left main coronary disease was associated with three vessel disease in 45% cases, two vessel disease in 20% cases and one vessel disease in 15% cases. The left main stenosis is frequently distal (60% cases), severe left myocardial dysfunction (EF < 40%) is found in 25% cases. 13 patients had coronary artery by pass graft with favourables outcome in all patients. The mortality was evaluated at 20% cases, only in medical group.