Objectives We aimed to describe the procedural characteristics and 5-year outcome of consecutive patients undergoing unprotected left main coronary artery (ULMCA) percutaneous coronary intervention (PCI) at our tertiary care centre between 1 January 2007 and 31 December 2008. Methods and results 76 patients underwent ULMCA PCI during the study period. Drug-eluting stents were used in 61. The mean EuroSCORE II, additive and logistic EuroSCOREs and SYNTAX score were 14.81, 10.2, 25.25 and 27.3, respectively. 30-day and 5-year mortality were 14.5% and 50%, respectively, with early mortality related exclusively to circulatory causes and late mortality being non-cardiac in 74%. Clinical presentation was a key determinant of 5-year mortality. During follow-up 1 patient suffered a non-fatal myocardial infarction (MI) related to ULMCA in-stent restenosis (ISR), 2 others suffered MI related to non-ULMCA lesions. Definite and probable stent thrombosis occurred in 1 (non-ULMCA stent) and 1, respectively. 3 patients had ULMCA ISR, 14 had non-ULMCA ISR necessitating redo revascularisation. Conclusions ULMCA PCI is a good treatment modality in patients who cannot undergo CABG. Clinical presentation and downstream disease have a major influence on the 5-year outcome. © 2016, Acta Cardiologica. All rights reserved.