Milrinone is a phosphodiesterase inhibitor that has vasorelaxant activity. The authors studied its effect on pulmonary haemodynamics in 12 patients with hypoxic pulmonary hypertension. After treatment with milrinone, mean pulmonary arterial pressure (from 4.61 +/- 1.41 kPa to 3.36 +/- 1.20 kPa, 1kPa = 7.5mmHg) and pulmonary vascular resistance (from 557.56 +/- 167.70 dyne.sec.cm-5 to 392.60 +/- 133. 81 dyne.sec.cm-5) decreased (P < 0.05), while cardiac output increased (from 5.11 +/- 1.62 L/min to 5.62 +/- 1.66 L/min) (P > 0.05). The systemic blood pressure (from 11.50 +/- 1.63 kPa to 10.71 +/- 1.83 kPa) and systemic vascular resistance (from 1476.64 +/- 531.52 dyne.sec.cm-5 to 1,236.49 +/- 410.18 dyne.sec.cm-5) also decreased (P > 0.05). but there was no change in arterial oxygen saturation (SaO2). The incidence of side effects were low, 4 patients developed tackycardia, and 2 patients developed ventricular premature beats. It is therefore, shown that milrinone is a potent pulmonary vasodilator.