Background New imaging modalities such as IVUS had improved results of stenting of the unprotected left main coronary artery (UPLM). The results of stenting UPLM without these new modalities but with meticulous care need to be studied more. Methods We analyzed data from 120 patients with UPLMD of > 50% subjected to stenting. All were stented by drug-eluting stents and followed for six months. Results 92 patients (77.3%) presented with ACS, of which 65 patients (54.6%) had no Previous Intervention, and 27 patients (22.7%) had a previous PCI. Left ventricular ejection fraction significantly correlates with complication, at 6 months follow up; all 16 patients with reported complications (100%) had baseline LVEF of Syntax score: 11 patients (55%) with a high score of more than 32 had adverse events, P = 0.004. Residual syntax shows a less significant correlation with a mean value of 7.3 in the complication group versus 4.9 in the other group (P = 0.016). Final kissing balloon inflation shows no statistically significant difference. Conclusions PCI in UPLM is a safe, feasible option with a high technical success rate and acceptable outcome at follow-up even without the utilization of IVUS