Coronary heart disease is a type of disease caused by ischemia and necrosis in the coronary arteries that supply blood to the heart due to stenosis. To date, the exact cause of coronary artery disease is not known, and no cure can be found yet, as in the case of pneumonia and other diseases. Of course, medical research has also found that there are a variety of conditions that are likely to cause the clinical prevalence of coronary heart disease, such as: hypertension, diabetes, hyperlipidemia, peripheral vascular disease, familial coronary heart disease, smoking, obesity, high-fat diet, lack of exercise and so on. But with one or more of the above conditions, coronary heart disease does not necessarily occur, so we cannot yet call it the cause of coronary heart disease, but only call them risk factors for coronary heart disease. The more risk factors mentioned above, the higher the risk of coronary heart disease, the earlier the onset of the disease and the more serious the disease tends to be, therefore, the general public should actively pay attention to and control their own coronary heart disease risk factors. Therefore, the general public should pay attention to and control their own risk factors. The American Heart Association and other organizations recommend that people over the age of 20 should be screened for atherosclerosis and other diseases, and that intensive interventions should be made for high-risk patients to prevent or delay the onset and development of coronary heart disease. However, for patients who already have coronary heart disease, one of the questions they often face is whether stenting or bypass is better. It should be added and clarified here that besides stenting and bypass, standardized drug therapy is also an important tool that cannot be ignored and may have better effect than stenting and bypass in some cases. For those patients who are definitely going to undergo revascularization (stenting or bypass), the following points can be considered: Stenting and bypass are both well-established techniques for the revascularization of coronary artery disease, but each has its own advantages and disadvantages, and each has its own risks. Coronary artery bypass grafting, commonly known as coronary artery bypass grafting, was invented in the 1960s and simply involves drawing a vessel from the ascending aorta across the stenosis of the coronary artery to connect with the normal segment of the distal artery, which is equivalent to building a bridge to the coronary artery. The initial bypass surgery must be performed under hypothermic anesthesia and extracorporeal circulation, and the heart must be stopped for a period of time, making it a relatively risky procedure. At the same time, the bridge vessels used in the initial bypass surgery were taken from the saphenous vein in the patient’s lower extremity, and the life span of the bridge vessels was limited. Nowadays, the bypass surgery has improved a lot, mostly using internal mammary artery bypass, which can be maintained for a longer period of time after surgery; many hospitals have carried out non-stop bypass surgery at room temperature, which reduces the risk of surgery; in addition, patients with simple anterior descending branch lesions can use small incision minimally invasive bypass, without cutting the sternum, which reduces the trauma of surgery. In the 1990s, intracoronary stents were gradually used in clinical practice, which is commonly known as “heart stent”. The traditional stent is made of medical stainless steel, but in recent years, drug-eluting stents have been used on a large scale, and the restenosis rate has been reduced to less than 10%. The total number of cases in China has now reached more than 100,000 per year, and is increasing at the rate of tens of thousands of cases per year, but there is still a large gap with developed countries in Europe and the United States (the number of interventions in the United States is more than 2 million cases per year). In comparison, stenting and bypass surgery have their own merits, and there is no simple question of who is better than whom. Generally speaking, the long-term survival rate of patients is similar between stenting and bypass surgery. The advantage of stenting is that it is easy to operate, less invasive, and to some extent repeatable, but it requires long-term antiplatelet medication after surgery, and there are relatively more angina recurrences that require re-intervention. In contrast, fewer symptoms recur after bypass surgery, but the surgery is more traumatic, the surgical risk is higher, and repeated surgery is almost infeasible. The key is to consider and choose according to the characteristics of the patient’s lesion, the systemic condition, the presence of other diseases, whether the patient can adhere to the medication as prescribed, and the affordability. If a patient has a heart valve lesion that requires valve replacement surgery, or if a ventricular wall tumor formed after myocardial infarction affects cardiac function and requires ventriculotomy, or if acute myocardial infarction is combined with mechanical complications such as septal perforation, papillary muscle or tendon rupture, bypass surgery should be selected. If there is a combination of other systemic diseases requiring surgical treatment, or if the coronary lesion is extensive and estimated to require implantation of many stents, then bypass surgery is recommended as the first choice. If there is a left coronary artery trunk lesion, bypass surgery should be preferred. If surgery is contraindicated, drug-eluting stents can be considered for implantation by an experienced interventionalist in a large hospital with experience. Most patients with coronary artery disease can now be effectively treated by stent placement. Drug-eluting stents are preferred for patients with diabetes, anterior descending branch lesions, small vessel lesions, long lesions, and restenotic lesions. Conversely, patients with short lesions on larger vessels and poor compliance who cannot adhere to medication should be considered for bare metal stents.