Coronary disease carries significant morbidity and mortality globally. The pandemic of obesity and diabetes combined with an aging population have resulted in a significant proportion of patients with multivessel coronary disease, the management of which poses significant challenges. A number of advancements in coronary intervention have emerged in the last few years allowing effective percutaneous management of complex coronary disease. In this review we examine the evidence base underpinning multivessel percutaneous coronary intervention across the spectrum of stable and acute coronary syndromes.