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Cardiac catheterization is performed routinely in hospitals all around the world. Extensive analysis of complications has been performed in the 1980s and early 1990s. However, because of the new therapeutic innovations based on advanced catheter technologies, these data may not apply to the present situation. Still, there are few data about procedural complications of diagnostic cardiac catheterization over the last 10 years. A total of 7,412 consecutive diagnostic cardiac catheterizations were performed between January 1990 and December 2000 and prospectively assessed in a registry. There were a total of 63 complications, of which 40 were minor and 23 major. Thus, the overall complication rate was 0.8%, with a mortality rate of 0%. Univariate analysis showed lower overall complication rate of senior physicians (> 500 coronary angiographies performed; OR = 0.58; 95% CI = 0.34-0.98; P = 0.04), smaller catheter size (< 6, 6, > 6 Fr: OR = 2.6; 95% CI = 1.53-4.41; P = 0.0004), and a higher rate in patients having left and right heart catheterization (OR = 2.62; 95% CI = 1.46-4.7; P = 0.003). Major complications were associated with larger catheters (< 6, 6, > 6 Fr: OR = 2.35; 95% CI = 1.0-5.51; P = 0.05), whereas vascular complications occurred more often with higher body weight (per 10 kg: OR = 1.4; 95% CI = 1.01-1.95; P = 0.04). Overall complication rate in diagnostic coronary angiography is very low and related to the experience of the performing cardiologist and catheter size. The only predicting risk factors for major complications in coronary angiography were catheter size and body weight.