To examine coronary revucularization and consider improvement of outcome of patients (pts) with one or two occluded coronary arteries and no significant stenosis in the remaining artery, we examined the events in 115 such pts with normal left ventricular function, no previous myocardial infarction or coronary revascularizatioD (Group 1) and 227 pts with prior myocardial infarction (Group 2), There were 90 pts with one- and 25 pts with two-vessel occlusion in Group 1 and 164 pts with one- and 63 pts with two-vessel occlusion in Group 2. During a mean follow-up of 60 months, there were 3 deaths and 6 myocardial infarctions in Group 1, and 14 deaths in Group 2. The pts with events did not differ from those without: in number of occluded arteries, collaterals, age, diabetes mellitus, hypertension or medications. Thus, the event rate was low in pts with one- or two-vessel occlusions and normal left ventricular function (death 0.5%/year and myocardial infarction 1.5%/year). Even in pts with left ventricular dysfunction, the death rate was only 1.2%/year. Coronary revascularization is unlikely to improve survival in such pts and, thus, should be reserved for those with serious symptoms.