We studied the clinical, hemodynamic and angiographic findings of 34 women (W) and of 184 men (M) with significant (greater than or equal 50%) CAD. W, compared to M, presented a higher incidence of systemic hypertension (p less than .025), while less frequent were among W smoking habits (p less than .001), history of old myocardial infarction (MI) (p less than .005), and patients in III-IV NYHA class (p less than .025). Left ventricular (LV) dP/dt was higher in W than in M (p less than .005). At coronary arteriography, single vessel disease (SVD) was more frequently found in W than in M (70% vs 23%, respectively, p less than .001); this findings was more evident in patients under 50 years of age (100% vs 30%, respectively, p less than .055). Prevalence of left anterior descending (LAD) over right (RCA) and circumflex (Cx) coronary artery stenoses was more marked in W than in M, especially in patients under 50 years of age (SVD of the LAD in 67% and of RCA in 33% of young W). Poor angiographic run-off of LAD was found in 21% of W, and only in 10% of M. In 2 of the 3 W with poor run-off of LAD operated on, a coronary bypass on the distal LAD was no technically feasible. At left ventriculography, a lower frequency of LV segmental wall motion abnormalities was found in W than in M, especially in patients with no history of MI (p less than .001). In summary, W with significant CAD, compared to age matched M, presented in our experience with a higher frequency of SVD and of LAD stenoses, and with a better LV contractile performance at left ventriculography. Furthermore, in W LAD more frequently showed a poor angiographic run-off. Such findings may bear important implications on the indication and results of coronary surgery in W with CAD.