Rotational atherectomy was introduced with a view to approaching percutaneously, cases that were suboptimal or unsuitable for conventional percutaneous transluminal coronary angioplasty (PTCA). In this article we present our findings for a period of two years starting in April 2001, when 60 procedures were performed on 54 patients. We found the procedure to be successful in B2 and C type lesions. It is our opinion that the lower burr-to-artery ratio used in our cases was significantly beneficial in decreasing immediate complications related to the procedure. Complimentary PTCA and stenting improved the angiographic end result. Using this strategy, we have achieved very acceptable clinical results.