Background: Coronary vasospasm is one of known causes for ischemic chest pain, however little data is available regarding its characteristics in teenagers as compared with those of elderly patients (pts). Methods: A total 3034 consecutive pts underwent coronary angiography with acetylcholine (Ach) provocation test were enrolled for the study. Study population were divided into according to age into 2 groups (Up to 20 years: 36 pts & more than 20 years: 2998 pts) .Significant CAS was defined as transient >70% luminal narrowing with chest pain and/or ST segment changes. Results: Baseline characteristics were similar between the two groups except that teenagers group had more males (75% vs.47.7%, p=0.001), while older group had more hypertension (47% vs.11.1%, p<0.001) & dyslipidemia (18.8% vs.0%,p=0.004). After the adjustment of baseline differences, there was a trend toward higher incidence of ischemic chest pain in the elderly group during the Ach provocation test. However, other clinical & angiographic characteristics of Ach test were similar between the two groups (Table). Conclusions: Even in teenagers, coronary vasospasm assessed by (Ach) provocation test showed similar clinical and angiographic parameters to elderly group during the test.