Coronary stent technology has rapidly evolved from a mechanical solution to abrupt vessel closure and elastic recoil following plain balloon angioplasty, to become a vector for local drug delivery and modification of coronary plaque pathophysiology. The advent of drug-eluting stents (DES) has significantly reduced restenosis, although there is increasing concern over the risk of late stent thrombosis, particularly following cessation of antiplatelet therapy. Here we consider the limitations of the current generation of DES, and review recent advances in platform, carrier, and pharmacological technology, and their place in future clinical practice.