Among 2,353 coronary angiographies (from 1.10.1984 until 30.9.1987) four lethal cases were seen. In two cases there was evidence for a causal relationship between coronary angiography and the lethal outcome (0.9%). Possible mechanisms of death are discussed. The clinical course and the time sequence between coronary angiography and the death are considered to be important criteria of a causal relationship.