Seven patients with coexistent Wolff-Parkinson-White (WPW) syndrome and variant angina pectoris underwent surgical interruption of an accessory atrioventricular conduction pathway. In two of these patients, perioperative coronary artery spasm occurred. One patient had a perioperative myocardial infarction and the other patient treated successfully had no infarction. Nitroglycerin and nifedipine were administered during and following operation in the other 5 patients without perioperative coronary artery spasm. No adverse effect was observed in the intraoperative electrophysiological study. Combined therapy of intravenous nitroglycerin administration and sublingual nifedipine administration are useful in the perioperative management of patients with coexistent WPW syndrome and variant angina pectoris.