This retrospective study evaluated angiographic, procedural, and in-hospital outcomes of chronic total occlusion percutaneous coronary intervention (CTO-PCI) at Aga Khan University Hospital, Karachi, Pakistan, from January 2020 to December 2022. Among 55 patients with at least one identified CTO, 38 presented with low left ventricular ejection fraction (LVEF) and 17 with normal LVEF. Despite a high prevalence of complex lesions (elevated J-CTO scores), the procedure was successful in 50 cases (91%). There were no significant diffe-rences in outcomes between successful and unsuccessful CTO-PCI cases relative to the studied variables.  Key Words: Chronic total occlusion, Left ventricular ejection fraction, Percutaneous coronary intervention outcomes.