With the substantial advances in technology and further refinements in the technique of coronary angioplasty, the potential for and manifestations of complications may have changed from those observed in populations studied previously. We describe a rare complication of percutaneous transluminal coronary angioplasty (PTCA), a large air embolus obstructing coronary flow, which is related to the newer technology. The air embolus was successfully extracted by aspiration through the balloon angioplasty catheter.