Due to its potential prognostic implications and technical complexity, revascularization of left main coronary artery (LMCA) disease requires careful consideration. It is important to follow appropriate lesion preparation and carefully optimized stenting in order to offer patients a treatment option as effective as coronary artery bypass grafting. For this reason, intravascular imaging, and especially intravascular ultrasound, is becoming a key procedural step in LMCA percutaneous coronary intervention. Accurate assessment of LMCA lesions is crucial in determining stenting strategies and optimizing procedures!