Background : The long-term prognosis of Korean patients with variant angina is unclear. We performed this study to evaluate the long-term outcome and clinical as well as angiographic characteristics of patients with ergonovine induced coronary vasoconstriction in Korea. Method : We evaluated 147 patients with ergonovine induced coronary spasm who were followed for a mean of 26 months (range 16 to 36). We reviewed the clinical characteristics, ECG changes during ergonovine testing and the angiographic findings including underlying coronary artery stenosis, type of vasoconstriction and the involved vessel. Results : Twenty-four patients (16.3%) had significant luminal narrowing, more than 50% of the coronary artery (16 in one vessels, 8 in two vessels). The electrocardiographic findings at the time of coronary spasm were ST segment elevation in 26 (17.6%) among the 147 cases, ST segment depression in 24 cases (16.3%), T wave inversion in 21 cases (14.2%) and no change in 75 cases (51%). The right coronary artery was the most common site of coronary artery spasm (80%). In addition, a focal spasm over a segment length of spasm less than 2 cm in one vessel (39.4%) was more prevalent than a diffuse spasm in one vessel (33.3%) or a multivessel spasm (27.2%). During the follow-up period, 14 patients (9.5%) developed major adverse cardiac events (MACE). 14 patients (9.5%) were rehospitalized for treatment. Two patients (1.3%) had a non-ST segment elevation myocardial infarction. There was no death among the 147 patients with variant angina. There were no significant differences in the MACE among the spasm types (focal, diffuse, multivessel). The multivariate analysis showed that smoking, underlying coronary artery stenosis with more than 50% luminal narrowing, and ST segment elevation on ECG during ergonovine testing were significant predictors of MACE (p<0.05). Conclusion : The long-term prognosis of Korean patients with variant angina is very good. The patients with underlying significant coronary stenosis and vasomotor dysfunction, with ST segment elevation during ergonovine testing and with coronary risk factors such as smoking must be followed closely. .