Transmyocardial laser revascularization is a new treatment modality for patients with chronic angina that is refractory to traditional management. A laser is used to create full-thickness channels through areas of ischemic myocardium. Transmyocardial laser revascularization is performed in an effort to improve myocardial oxygenation, eliminate or reduce angina, and improve functional status, Transmyocardial laser revascularization currently is undergoing clinical trials. Early results have demonstrated significant reduction in anginal symptoms. Long-term efficacy of transmyocardial laser revascularization remains to be determined.