Coronary bifurcation lesions, a subgroup of complex lesions, account for 15% to 20% of all routine percutaneous coronary interventions (PCI). The placement of drug-eluting stents (DES) is now the routine means of PCI for bifurcation lesions, due to the superior imaging and clinical outcomes of DES compared to bare metal stents. Technical modifications include the application of posthyperbaric dilation, para-anastomotic dilation, and intravascular ultrasound guidance to screen suitable lesions for treatment by double stenting and after main stem single stenting, withholding treatment of branches with poor imaging results that are not functionally significant, but instead lead to better outcomes, even similar to those of non-bifurcated lesions. Interventional treatment of bifurcation lesions using DES has been considered a predictor of in-stent thrombosis (ST). However, the available reported ST rates are still low and independent of the treatment technique. Therefore, given the increasing number of complex lesions successfully treated with PCI. Contemporary randomized studies have shown no benefit of conventional stenting of both trunk and branches compared to stenting of trunk and, if necessary, branch stenting in terms of clinical and imaging outcomes. Therefore, the branch stenting strategy is currently the preferred strategy when necessary; however, more complex dual stenting techniques may be necessary as an intention-to-treat strategy in some cases.