Objective: To determine the clinical and epidemiological features in young and old age patients presenting with chest pain syndrome, we analyzed KCAR database. Method: From 2004 to 2005, 5803 patients admitted for the chest pain evaluation were registered to KCAR database from five Korean university hospitals. All patients were divided into three groups according to the ages; age ���40(n=118), age 41-70(n=4049) and age ���71(n=1636). All demographic features, coronary angiographic features were analyzed in different groups. Results; From the demographic data, we observed that in comparison to elderly patients, young patients with age���40 are more frequently male (87%) and smokers (71%), but showed a lower prevalence of hypertension (30%) and diabetes (7%) and had a lower rate of previous stroke or myocardial infarction than old patients. On lipid profiles, young patients revealed much higher total cholesterol, triglyceride and LDL-cholesterol level than older groups though there was no difference in HDL-cholesterol level. The younger patients more likely to be prsented without coronary artery stenosis. Most common presentation was ST-segment elevated myocardial infarction in young patients compared with unstable angina in older patients. Conclusions: The clinical and epidemiologic features in patients with IHD are different in different age groups, so we have to modify the approaching method according to the patient ages.