Background: Coronary artery disease remains a leading cause of morbidity and mortality worldwide. Percutaneous coronary intervention (PCI), particularly on the left main coronary artery (LMCA), has emerged as a significant treatment option. Understanding the long-term outcomes of such interventions is crucial for optimizing patient care and guiding clinical decisions. Objective: To evaluate the three-year clinical outcomes of PCI procedures performed specifically on the LMCA. Methods: This study, conducted at the Peshawar Institute of Cardiology from April to September 2023, received ethical committee approval. Participants were identified through a review of medical records for individuals who underwent LMCA PCI. Data were collected via a pre-designed questionnaire and analyzed using SPSS version 26. Results: The study included 75 patients, with an average age of 61.49±10.41 years, comprising 57 males (76.0%) and 18 females (24.0%). During the hospital stay, complications included thrombectomy in 1 patient (1.3%), 2 deaths (2.7%), 1 case of bleeding (1.3%), and 1 cardiac arrest successfully reverted (1.3%). Post-discharge, 2 additional deaths (2.7%) occurred within one month, and 1 patient (1.3%) experienced angina after three months. The three-year follow-up revealed a mortality rate of 6 patients (8.0%). Conclusion: The study concludes that complications following LMCA PCI were relatively infrequent. However, it emphasizes the need for continued research to further elucidate the long-term outcomes of this procedure.