BACKGROUND AND OBJECTIVES: Previous studies examining the gender differences in patients undergoing percutaneous coronary intervention (PCI) have reported that women have a higher in-hospital mortality rate, and are at an increased risk for adverse outcomes compared to men. The aim of this study was to determine whether or not Korean women undergoing contemporary PCI have a higher risk than men. SUBJECTS AND METHODS:Seventy eight elderly patients with 105 lesions, including 33 women (47 lesions, 81.9+/-1.97 year-old) and 45 men (58 lesions, 81.6+/-1.74 year-old) who underwent PCI from Jan 1996 to Apr 2001 were enrolled in this study. The demographics, angiographic findings and the clinical outcomes of each gender were compared. RESULTS: Clinical diagnosis and risk factors for atherosclerosis for males and females were similar with the exception of their smoking status (36.7% vs. 14.8%, p=0.002) and stroke history (9.1% vs. 0%, p=0.038). There were no differences in the major in-hospital complications including cardiac death (12.1% vs 15.6%, p=0.75), acute myocardial infarction (AMI:3% vs. 0%, p=0.42), rescue PCI (3% vs. 0%, p=0.42) and emergent coronary artery bypass grafts (CABG:6.1% vs. 11.1%. p=0.44) between the two groups. A twelve-month clinical follow-up showed that the major adverse cardiac events including cardiac death (17.8% vs 28.9%, p=0.27), AMI (0% vs. 5.3%, p=0.5) and repeated revascularization (20.7% vs. 15.8%, p=0.6) in males and females were also similar. CONCLUSION: PCI in Korean female patients older than 80 years can be performed with a comparable procedural success rate and clinical outcomes to those of elderly male patients.