Background and Objectives: Despite of technical feasibility, Transradial coronary intervention had more benefit than transfemoral approach in regard to hospital duration and patients comfort after procedure. But it is not certain that this benefit is same applicable to extremely old age in clinical outcomes. So we compared clinical and procedure outcomes and characteristic in patients over the 85 years old treated with transradial or transfemoral approach. Subjectives and Method: Total 34 patients were received coronary intervention at Gangneung Asan hospital between 1996 and June 2004. Radial approach is 21 patients (age,87짹2.4) and tranfemoral approach in the remaining 13 patients (age,86짹1.8). Statistical difference is not demonstrated in age, gender and comorbidities between two groups. And also no difference in procedure success rate(transradial 71% vs transfemoral 86%), 12 month major adverse cardiac event(10% vs 23%, p=0.08) and local vascular complication rate(0% vs 8%). we found the significant shorter hospital duration(10짹0.8 day vs 13짹1.8 day, p<0.01) in transradial group and more frequently performed transfemoral approach in emergent or urgent situation. The reason of this preference is due to feasibility of emergent procedure, such as IABP or ventricular pacing. Total failure of transradial approach is four patients(11%). Two were puncture failure and remaining were subclavian artery tortuosity. Conclusion: transradial coronary intervention is same feasible and safe technique to transfemoral approach in over the 85 years old patients. Procedure success or completeness is not related with approach type and so transradial approach is good alternatives to transfemoral intervention in old patients.