Abstract: AIM To evaluate the safety and efficacy of percutaneous coronary intervention (PCI) for the treatment of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in patients over 80 years old. METHODS A total of 175 NSTE-ACS patients with confirmed coronary artery stenosis 70%-90% by coronary angiography were divided into a PCI group and an optimal drug therapy group. Patients in the PCI group underwent PCI 3-7 days after the onset of NSTE-ACS and those in the optimal drug therapy group received only optimal drug treatment. The clinical characteristics of the two groups were observed and major adverse cardiac events during the 1-year follow-up were recorded. RESULTS When compared with those in the optimal drug therapy group, the risk of re-admission for cardiac problems, urgent revascularization, and incidences of recurrent angina in the PCI group were significantly decreased. There were no statistical difference in all-cause mortality, stroke, and major bleeding between the PCI and optimal drug therapy groups. CONCLUSION PCI technique is safe and effective for the treatment of NSTE-ACS in patients over 80 years.