BACKGROUD: Whether the bifurcation angle may have an impact on outcome in patients undergoing bifurcation percutaneous coronary intervention (PCI) using T-stenting and small protrusion (TAP) technique with drug-eluting stent is unknown. We sought to investigate the effect of the bifurcation angle on long-term clinical outcomes in patients undergoing bifurcation PCI using TAP technique. METHODS: Of 350 bifurcation PCI cases with provisional approach performed between March 2005 and December 2008, 130 were performed using TAP technique. Patients were divided into low-angle and high-angle groups using the median bifurcation angle (60째) as the cut point. RESULTS: High-angle group had a higher likelihood of left main bifurcation lesions (63.2% vs. 16.1%, P < 0.01). In the high-angle group, the diameter of side branch (SB) stents implanted was bigger than that of low-angle group (2.8 짹 0.3 mm vs. 3.1 짹 0.4 mm, P < 0.01). The mean length of SB stents was longer in the low-angle group than in the high angle group (21.9 짹 6.8 mm vs. 18.4 짹 8.2 mm, P = 0.01). Intravascular ultrasound and final kissing balloon inflation were performed in all patients. Procedural success was 96.8% in the low-angle and 97.1% in the high-angle group (P = 0.93). In 7 cases (5.4%), the SB ostium was not fully covered. There was no difference in the incidence of the uncovered SB ostium between the groups (4.8% in the low-angle group vs. 5.9% in the high-angle group, P = 0.79). The length of protruding stents was similar between the groups (2.8 짹 1.5 mm in the low-angle group vs. 2.5 짹 1.5 mm in the high-angle group, P = 0.22). Major adverse cardiac events [MACEs: cardiac death, myocardial infarction, or target lesion revascularization (TLR)] occurred in 22 patients (16.9%) during a median follow-up of 33 months. Both groups had comparable incidences of MACE and TLR (16.1% in the low-angle group vs. 17.6% in the high-angle group, P = 0.82 and 14.5% vs. 16.2%, P=0.79, respectively). CONCLUSION: Low-bifurcation angle was not associated with increased incidence of MACE and TLR in patients undergoing bifurcation PCI using TAP technique.