Objective: A novel antithrombotic agent, lumbrokinase, was evaluated in this pilot study for its efficacy in the treatment of symptomatic stable angina. Design: This was a single-armed cohort study. Settings: The study was conducted at the National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia. Subjects: The study comprised 10 patients who had coronary artery disease and stable angina and who consented to the trial. Intervention: Patients were treated with oral lumbrokinase for 30 consecutive days in addition to their standard medical therapy. Outcome measures: Stress technetium-99m sestamibi myocardial perfusion imaging (MPI) was performed before and at the conclusion of the active treatment period. The degree and extent of inducible ischemia observed on the myocardial perfusion images were evaluated using the previously validated semiquantitative indices (Summed Stress Score and Summed Difference Score). Results: Following active treatment, the mean Summed Stress Score and Summed Difference Score deceased by 39% and 37%, respectively. The anginal symptom was ameliorated in 6 of 10 patients. No adverse reaction including major or minor bleeding was observed. Conclusions: This paper represents the first description of the use of oral lumbrokinase in the treatment of chronic coronary artery disease with objective assessment using MPI. Oral lumbrokinase improves regional myocardial perfusion in patients with stable angina.