AbstractTwo hundred thirty Swan‐Ganz catheters were inserted into 225 patients. Meticulous attention was paid to techniques of insertion and post‐insertion catheter care. The preferred route of insertion was via the right internal jugular vein.Minor problems included neck hematomas in 5 attempts (2.2%), catheter migration after insertion in 13 cases (5.6%), and 1 balloon rupture. Only 9 of 230 catheter insertions (3.9%) were associated with major complications. Six of 9 problems, classed as major, were transient arrhythmias which occurred during catheter insertion but were rapidly corrected. In one patient the catheter knotted and had to be removed in the cardiac catheterization laboratory. Two patients (0.9%) suffered non‐fatal pulmonary artery injuries. There were no episodes of catheterrelated sepsis nor were there any deaths attributed to the use of the catheter.We conclude that the flow‐directed pulmonary artery catheter is a relatively low‐risk monitoring device.