PURPOSE--To study the short and long-term follow-up of patients with left main coronary artery disease (LMCAD) and age over 65 years, by comparing the results with patients under 65 years-old. METHODS--Twenty-two patients with LMCAD and mean age of 69 +/- 3.5 years (group I) were underwent isolated coronary artery bypass grafting (CABG) and compared to 31 patients with LMCAD, mean age of 54 +/- 7 years (group II), who also underwent isolated CABG. The life-table Kaplan-Meyer method was used to estimate the post-operative survival. The chi-square and Student "t" test were used when necessary. RESULTS--Despite higher operative mortality in group I (9.1 x 3.2), the difference was statistically not significant. The operative morbidity was similar in both groups. Actuarial survival at 4 years was 85 in group I and 95 in group II. Actuarial survival free of cardiac events was 69 in group II and 75 in group II. CONCLUSION--The CABG is well tolerated and had low morbidity and acceptable mortality in old patients with LMCAD. The long-term survival in these patients was very similar to the younger patients.