Of the 210 patients who underwent direct coronary surgery for stable and unstable angina pectoris and acute myocardial ischemia, 187 were followed up after the operation for 11 months on the average. Operative mortality was 11%. Among the 187 patients, 46.5% were completely relieved of angina, 36.4% showed moderate improvement, and 16.9% had no improvement in their condition. Patients with prior myocardial infarction had a substantially diminished success rate for relief of angina. Postoperative angiography in 125 patients demonstrated high correlation between clinical response and graft patency. It is concluded that direct coronary surgery provides partial or complete relief of angina pectoris in 82.9% of patients, and this response to operative treatment may be directly related to the success of the surgery ensuring patency of the graft, evidence of which is demonstrated by angiography.