Percutaneous transluminal angioplasty via the femoral approach was attempted through internal mammary artery grafts in 11 patients who presented with distal anastomotic stenoses or distal native coronary artery stenoses and angina pectoris. The procedure was technically successful in 10 patients and no major complications occurred. During follow up there was one late death, but all 10 surviving patients showed functional improvement. Percutaneous transluminal angioplasty seems to be a safe and effective treatment for stenoses of internal mammary artery grafts. This is an effective technique for treating the increasing number of patients who are likely to present with stenoses of these grafts.