Objective To investigate the clinical manifestations of premenopausal women with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). Methods The clinical data of 74 premenopausal women and 109 postmenopausal women with CAD who underwent PCI in The First Medical Center of Chinese PLA General Hospital from Jan. 2014 to Dec. 2018 were retrospectively analyzed. The general data, coronary artery lesion characteristics and incidence of major adverse cardiovascular event (MACE) within 1 year after surgery were compared between the 2 groups. The independent risk factors of the postoperative MACE were investigated by multivariate logistic regression analysis. Results Compared with the postmenopausal group, the prevalence rates of hypertension and smoking and the levels of low density lipoprotein-cholesterol, triglyceride and total cholesterol were significantly lower in the premenopausal group (41.9% ［31/74］ vs 72.5% ［79/109］, 0 vs 13.8% ［15/109］, ［2.40±0.86］ mmol/L vs ［2.71±0.95］ mmol/L, ［1.40±0.74］ mmol/L vs ［1.69±0.97］ mmol/L, and ［3.88±1.02］ mmol/L vs ［4.39±1.05］ mmol/L, all P＜0.05), while the prevalence of autoimmune diseases and the left ventricular ejection fraction were significantly higher in the premenopausal group (14.9% ［11/74］ vs 1.8% ［2/109］ and ［62.4±4.9］% vs ［60.0±5.4］%, both P＜0.05). The incidence rates of left anterior descending artery and left main disease lesions were significantly higher in the premenopausal group than those in the postmenopausal group (83.8% ［62/74］ vs 67.9% ［74/109］ and 14.9% ［11/74］ vs 4.6% ［5/109］, both P＜0.05). The incidence of MACE within 1 year after PCI was significantly higher in the premenopausal group than that in the postmenopausal group (12.2% ［9/74］ vs 3.7% ［4/109］, P＜0.05). Multivariable logistic regression analysis showed that premenopause was an independent risk factor of MACE within 1 year after PCI in female CAD patients (odds ratio＝3.635, 95% confidence interval 1.075-12.283, P＝0.038). Conclusion Premenopausal females with CAD have higher incidence rates of left anterior descending and left main artery lesions and higher incidence of MACE within 1 year after PCI.