To assess the outcome of stenting in patients with severe left ventricular dysfunction, 149 consecutive patients undergoing coronary stenting with an ejection fraction less than or equal to 40% (mean 35 +/- 10%) were analyzed. Angiographic and clinical success were achieved in all patients. At follow-up of at least 6 months (mean: 24 months), 130 patients (89%) were alive and 124 (85%) were less symptomatic than before percutaneous coronary intervention (PCI). We conclude that PCI can be performed safely in patients with depressed left ventricular ejection fraction and is associated with improved symptoms at long-term follow-up.