Operator radiation exposure during percutaneous transluminal coronary angioplasty as compared with that during routine coronary angiography is unknown. Therefore, cumulative radiation exposure at operator eye level was measured in two physicians (operators 1 and 2) during performance of coronary angioplasty and routine coronary angiography. The physicians participated together during angioplasty in eight patients; they performed routine angiography separately in eight patients each. Cumulative radiation exposure for eight angioplasty procedures was 140 mrads for operator 1 and 130 mrads for operator 2. In contrast, exposure during eight routine angiograms was 80 mrads for operator 1 and 60 mrads for operator 2. Mean cineangiographic time per case was similar (p = NS) during angioplasty (44.1 +/- 14.0 seconds for both operators) and angiography (49.7 +/- 6.1 seconds for operator 1, 47.6 +/- 16.1 seconds for operator 2). In contrast, fluoroscopy time was longer (p less than 0.01) for angioplasty (34.5 +/- 17.7 min) compared with angiography (13.1 +/- 5.1 min for operator 1, 13.7 +/- 8.2 min for operator 2). Thus, operator radiation exposure during percutaneous transluminal coronary angioplasty was, on average, 93% greater than during routine coronary angiography and was related to the duration of fluoroscopy rather than cineangiography.