We compared the efficacy and safety of percutaneous renal angioplasty for the treatment of renovascular disease in younger (aged less than 60) and elderly patients (aged 60 or more). Angioplasty yielded a higher technical success rate in younger patients while complications occurred more frequently in the elderly. Among patients with a successful angioplasty, the rate of cure or improvement of hypertension tended to be higher in the younger patients. The efficacy and safety of renal artery angioplasty may be limited in elderly patients by age-associated atheroma of renal and extra-renal arteries.