Introduction and objectives. Each year the Spanish Society of Cardiology Working Group on Cardiac Catheterization and Interventional Cardiology reports on the data collected by the national registry of procedures performed. This report covers 2009. It contains information on the implementation of interventional cardiology across Spain and enables comparisons to be made with other countries. Methods. Data were provided voluntarily and were analyzed by the Working Group's steering committee. Results. Data were submitted by 126 hospitals that mainly performed procedures in adults: 74 public and 52 private. Overall, 137,166 diagnostic procedures were carried out, including 122,961 coronary angiograms; the rate of 2664 coronary angiograms per million population was little changed from the previous year. The number of percutaneous coronary interventions increased by 2% to reach 63,075, which corresponds to 1391 per million population. In total, 102,850 stents were implanted (58.7% drug-eluting). In addition, 13,395 interventions were carried out during the acute phase of myocardial infarctions: this represents a 10% increase relative to 2008 and accounts for 21% of all percutaneous coronary interventions. The most frequent intervention for adult congenital heart disease was closure of an atrial septal defect, with 329 procedures. The most frequently performed valve procedure was mitral valvuloplasty, with 336 cases treated (success rate 96%), with the exception of percutaneous aortic valve implantation, which increased exponentially to a total of 426 in 2009. Conclusions. The most significant increases in activity were in procedures for ST-segment elevation acute myocardial infarction and in percutaneous valve implantation. There was only a modest increase in the use of all other diagnostic and therapeutic procedures.