Objectives: To perform a comprehensive PCI registry at Cairo University Hospitals (Al-Kasr Al-Aliny), including; Baseline demographic and clinical characteristics, Indications for PCI, Initial Assessment and Investigations, Angiographic findings, Percutaneous intervention, materials, devices, and complications, Medication at the time of PCI and at discharge, Short term in-hospital outcome, , and Adherence to existing guidelines. Background: Myocardial revascularization has been an established mainstay in the treatment of CAD; PCI has witnessed significant technological advances, with significant variation in the availability of resources between countries and within centers in the same country that may influence PCI outcome. Registry data are extremely important because of the information on patients who are frequently left out of clinical trials. Additionally, the registries allow an assessment of the acceptance and practice of new treatments by the medical community that tends to resist change despite supportive evidence and guideline recommendations for new types of therapy. Therefore, this registry gives a more realistic picture of our patient population profile that underwent PCI in the Cairo University Hospitals. Awareness of our reality may help the medical community adhere more strictly to the standard protocol set by international guidelines. Methods: We did prospectively registry from the beginning of January 2014 till the end of June 2014, of 272 patients who underwent PCI at Cairo University Hospitals (Al-Kasr Al-Aliny), and met the inclusion criteria were enrolled in the study. Results: Of the 272 patients enrolled for PCI, 106 (39%) presented with (STEMI), 31 (11.4%) with (NSTEMI), non-ST segment elevation MI (NSTEMI) in 31 (11.4%), UA was present in 33 (12.1%), and elective in 102 (37.5%). The mean age of these patients was 56.15 ± 8.53, more than two thirds of the patients were males 196 (72.1%). Hypercholesterolemia was the most prevalent risk factor detected in 224 patients (82.35%), 83.5% of PCI patients were overweight/obese (42.3% / 41.2%), hypertension was present in 198 patients (72.8%), and smoking was present in 185 patients (68%) [Current 134 (49.2%), former 51 (18.8)], most of them were male 179 (96.2%), and diabetes mellitus was found in 140 patients (51.1%). Femoral artery access the most frequently used technique (98.5% vs 1.5%) for radial access. Primary PCI was performed with a median door-to-balloon time of 3.72 hr for nontransfer patients. The majority of patients received medical therapy that is currently recommended by the guidelines. There was no significant difference between paid and free sections in the percent of use of DES to BMS. In-hospital mortality was 2.6%, it was 4.7% among ST elevation ACS (reached 7% of primary STEMI), 3.1% among Non ST elevation ACS (3.2% among NSTEMI, 3% among Unstable Angina), and non (0%) among elective patients. The general success rate was 95.5%, for non CTO lesions was 97.3% v 61% for CTO lesions. Conclusions: This registry has enabled us to determine the incidence and characteristics of PCI patients in Cairo-Egypt. Data of the PCI Registry provides a contemporary view of the current practice of invasive cardiology in the Cairo university hospitals. It has also showed us some obstacles that we need to overcome for the full implementation of published guidelines for the management of PCI patients. Dyslipidemia, hypertension, smoking, diabetes mellitus, and obesity are the risk factors associated with CAD, and that can be modified, treated, or controlled by changing lifestyle or taking medicine. The incidence of STEMI among Acute Coronary Syndrome patients is relatively high in Egyptian patients, and at a young age. Our results clearly demonstrate a good concordance between existing guidelines for medication at the time of PCI and medication at discharge. But also clearly demonstrate the discordance between existing guidelines for the time to PCI in Acute Coronary Syndrome, especially Non ST elevation ACS. There was no significant difference between paid and free sections of our hospitals. The Cairo University Hospitals (Al-Kasr Al-Ainy), in the percent of use of DES to BMS in CAD patients underwent PCI. In-hospital mortality rate in our registry was comparable with that reported in developed countries; also there is an improvement in the mortality rate in our hospitals. The success rate and outcomes of PCI in our registry are as good as international standards, and outcomes.