The EuroCTO club was established in December 2006. In 2007 it published its first consensus document on the recanalisation of Chronic Total Occlusions (CTOs), aiming to set standards on clinical indications, equipment, procedural safety, operator training and centre qualifications, as well as provide an update on material and technical developments. Since that time there have been considerable advances in techniques (both antegrade and retrograde) and dedicated equipment (wires, micro-catheters and CTO dedicated devices) that have changed the landscape of CTO angioplasty. In an effort to promote widespread application of CTO recanalisation in Europe, the EuroCTO club has written this updated consensus document reflecting the views of European operators. It is based on published evidence where available, and on consensus among the authors where issues of technique and strategy are concerned and no studies are available. The following is a summarised overview of the document. A complete, unabridged version is available online.