The acute and long-term results of coronary angioplasty in 295 patients with isolated, proximal left anterior descending coronary stenosis are reported. The angiographic success rate was 83·4% overall, but 90·5% for non-occluded arteries treated since 1985. Clinical success at hospital discharge was achieved in 79·7%. The median duration of follow-up was 2 years and vital status was established in 99·7% at census. Cumulative 5-year cardiac survival was 96·2% after successful angioplasty and 95·6% for all patients. Five-year freedom from all cardiac events including cardiac death, myocardial infarction and repeat intervention was 73·8% amongst successfully treated patients, and 63·0% for all patients. After angioplasty, patients had less angina, required less anti-anginal medication and were more likely to be in gainful employ ment. Our data indicate that coronary angiopasty is an effective long-term treatmenifor selectedpatients with single vessel disease involving the proximal left anterior descending coronary artery. © 1991 The European Society of Cardiology.