Percutaneous revascularization is a widely accepted procedure to treat patients with coronary artery disease. Since its first description in the 1970s, significant technological and pharmaceutical advances have occurred and subsequently reduced the complications associated with the procedure. Large, randomized controlled trials have provided additional evidence that percutaneous revascularization improves morbidity and mortality in patients with coronary artery disease. Over the last decade, devices designed to treat patients with more complex coronary artery disease have expanded the available therapeutic options and will likely contribute to a further decline in adverse events. Despite these advances, the management of patients with acute myocardial infarction, in-stent restenosis, and multivessel coronary artery disease remains challenging. The majority of evidence supports an early, aggressive approach in patients with acute ST-elevation and non-ST-elevation myocardial infarction. Ongoing clinical trials should help to further define the role of percutaneous interventions in the optimal management of patients with coronary artery disease.