Introduction: Radiofrequency catheter ablation (CA) is the preferred treatment for premature ventricular contractions (PVCs). Ionizing radiation has major side effects for both patients and personnel in the electrophysiology laboratory. Fluoroless procedures are routinely performed for atrial fibrillation and simple PVC cases. Nonetheless, left ventricular (LV) summit/intramural PVCs cases are more challenging and clinical outcomes and complications have been poorly studied in this category with the use of fluoroless ablation. Hypothesis: We aimed to compare acute, long-term success rate and complications between fluoroless procedures versus standard approach for left ventricular (LV) summit/intramural PVCs. Methods: We conducted a retrospective analysis of patients who underwent PVC ablation under fluoroscopy and non-fluoroscopy at two institutions. Results: A total of 41 cases were enrolled (male: 61%; mean age: 55 ). Twenty-five cases underwent ablation under fluoroscopy whereas 16 underwent non-fluoroscopy ablation. Acute success was seen in 88% of non-fluoroscopy cases compared to 87.5% in the fluoroscopy group ( p = 0.9). The PVC recurrence at 12 months was similar between both groups (non-fluoroscopy: 15% vs Fluoroscopy: 18%) ( p = 0.9). No complications occurred in any group. Conclusions: Fluoroless CA is an emerging technique in the treatment of LV summit/intramural PVCs that appears to have similar clinical outcomes and complications compared to conventional fluoroscopic procedures.