Abstract: AIM: To study and evaluate the clinical efficacy of percutaneous coronary intervention (PCI) surgery for small vessels in elderly coronary heart disease patients. METHODS: The subjects were chosen from the elderly coronary heart disease patients (aged over sixty) treated with PCI surgeries for small vessels (with diameter less than 3.0 mm) in our center from June 2007 to June 2010. Sirolimus drug-eluting stents were implanted by standard drug-eluting stent implantation techniques. Both pre-surgery and post-surgery, the subjects were given normal doses of medicine, including Aspirin, Clopidogrel and low molecular weight heparin. RESULTS: No major complications were detected during PCI surgery. MACE during the 6-month period after surgery was 7 cases (2.4%), during the 12-month period after surgery was 9 cases (3.0%) and during the 18-month period after surgery was also 9 cases (3.0%). CONCLUSION: The long-term efficacy of PCI surgery for small vessel coronary heart disease of elderly patients is also satisfactory.