Background. The treatment of patients with angma pectoris refractory to medical therapy and unsuitable for revascularization procedures is a challenging problem in the modern cardiology but it is not well standardized yet. Previous large retrospective studies and small prospective studies suggested beneficial effects of spinal cord stimutation (SCS) in these patients. Method. We organized a Prospective Multicenter Italian Registry of SCS to evaluate the short and long term clinical outcome of patients undergoing SCS device implantation because of severe refractmy angina pectoris and the clinical effects of this form of therapy. Patients were followed-up with periodic medical visits in out-patient clinics. Results. Overall, 104 patients were enrolled in the Registry (70 men, age 67.&17 years), most of whom (83%) had 3.vessel coronary artery disease. Average follow-up was 13.2+7.9 months, ranging from 6 to 24 months. Overall, 17 patients (16.8%) died during the follow-up period, 8 (7.9%) of whom of cardtac death. Among clinical variables, only age was found to be significantly associated both with total mortality (p=O.O4) and cardiac mortality (P=O.O2) on Cox regression analysis. At the last follow-up, a significant improvement of angina1 symptoms (>50% reduction of weekly angina1 episodes, compared to baseline) was reported by 73.0% of patients, and the Canadian Cardiovacular Society class of angina was improved by ~1 class in 80.5% and by x2 classes in 42.3% of patients. A relevant reduction in the rate of hospital admission and days spent in the hospital because of angina (pcO.0001 for both) was also observed. No life-threatening or clinically serious events were observed as related to the SCS treatment. Conclusions. Our prospective data show that SCS can be performed safely and is associated with a sustained improvement of angina1 symptoms in a relevant number of patients with refractory stable angina pectoris. suggesting that it should be seriously taken into account for the treatment of these patients.