Multivessel coronary disease is more common in elderly. What to choose as a primary strategy in elderly patients with stable angina: revascularization (percutaneous coronary intervention or aortocoronary bypass surgery) with intensive pharmacologic therapy and lifestyle intervention (optimal medical therapy) or optimal medical therapy alone? Clinical trials comparing these two approaches have shown that elderly benefit more from revascularization than younger patients. There is no doubt that multivessel disease requires a heart-team to select the optimal management. Age by itself is not a criterion to select the treatment strategies. One need to consider many other factors: medical findings, angiography, the patient's desire, social, cultural factors and other parameters. Patients should be given full and objective information.