The purpose of the study was to evaluate the long-term prognosis of ventricular tachycardia (VT) in patients without structural heart disease (HD). Methods: Holter monitoring, exercise test, echocardiography, right angiography, coronary angiography, and electrophysiologic study were performed in 810 patients with VT. Results: Eighty patients (mean age, 45 ± 17 years) had no apparent HD. VT was reproduced at electrophysiologic study in 62 patients. Mean follow-up was 9.7 ± 7 years. Initially, 91% were treated with drugs. Defibrillator was implanted in 4, including 2 for arrhythmogenic right ventricular cardiomyopathy diagnosed later. VT ablation was performed in 3 patients. Three patients older than 70 years died of nonarrhythmic cause. Other patients are alive without antiarrhythmic drug treatment in 50%. Three developed a dilated cardiomyopathy; and 2, atrial fibrillation. Conclusions: Invasive treatment was rarely required in patients with VT without HD. The prognosis was only dependent on the age and the pattern of electrocardiogram in VT.