Introduction: coronary artery disease involving the proximal portion of LAD is a known predictor of morbidity and mortality. Coronary stenting of LAD lesions is supposed to be associated with a high rate of procedural and clinical success and low rate of procedural complications.Methods: Between June 2000 and June 2001, 121 consecutive patients who underwent PTCA and stenting of 123 significant lesions of the LAD were prospectively studied. Results: angiographic success defined as (final DS%<20% by QCA) was obtained in (95%) and clinical success was achieved in (92%) of lesions. Adverse angiographic changes during the procedure included coronary dissection (17%), coronary spasm (3.2), slow flow (1.6), persistent stenosis (2.4%) and jailing of side branches in (4.8%). Major adverse cardiac events (MACE) included death (1.6%), MI (1.6%) and Re-PTCA (0.8%). Predictors of adverse angiographic changes included older age, (P=0.04), lesion calcification (P=0.002), bifurcation lesions (P=0.0017) and lumen irregularity (P=0.019). Clinical, angiographic and procedural variables were not significantly different in patients with proximal vs. non proximal LAD lesions. (MACE) were relatively higher in (P-LAD) lesions. Conclusion: PTCA and stenting of significant LAD lesions is associated with a high angiographic and clinical success rates. Predictors of adverse angiographic changes include older age. Lesion calcification, bifurcation and lumen irregularity.