Aim. To systematize the indications for myocardial revascularization in view of CA patterns in young adults with ACS and SA. Material and methods. Angiographic patterns of CA and independent risk predictors were analyzed in 126 young adults 27—40 years old (mean 38.5±0.3) with CAD including 19 (15.1%) patients younger 35 years (32,5±0,6). There were 64.3% of patients with stable angina (SA) including 60.5% with previous MI and 35.7% of patients with acute coronary syndrome (ACS) including 37.8% with previous MI. 90.5% patients were hospitalized for the first time; 9.5% of patients admitted repeatedly with recurrent angina in 5—48 months after revascularization. Incidence of first-time hospitalization in young adults with SA and ACS was 66.7 and 33.3% respectively, repeated hospitalization — 6.2 and 15.5%, respectively. Results. Young adults with ACS differed from SA group by dominance of patients younger 35 years in 20 and 12.3%; single-vessel lesion in 46.7 and 30.9%; one independent risk predictor in 66.7 and 30.8%, respectively. Young adults with SA differed from ACS group by early MI in 60.5 and 37.8% patients; lesion of ≥3 coronary arteries in 40.7 and 22.7%; prevalence of ≥2—3 risk factors in 69.2 and 30.8% patients, accordingly. Discrete coronary stenosis was observed in 97.1% young adults. Proximal segments were involved more often. 4.8% of patients had diffuse lesion and 10.3% — total occlusion. PCI — ratio in ACS and SA groups comprised 1.15:1 with revascularization of one CA in 78.3 and 55%; 2 CA in 13% and 45%; mean number of stents were 1.22±0.5 and 1.9±0.2, accordingly. CABG — ratio in groups with SA and ACS comprised 2.5:1 with 1-vessel grafting in 28 and 35%; 3 — vessels grafting in 52 and 40%, accordingly. Conclusion. More frequent but less volume PCIs were observed in young adults with ACS; frequent and multi-vessel CABG — in young adults with SA. These differences were tied with predominance of 1-vessel lesion in ACS — group and need for revascularization of ≥2—3 CA in SA — group.