While the treatment of LMS disease has historically lain in the realm of the surgery, rapid advancements in the field of percutaneous coronary intervention has provided another viable therapeutic option. Both the American and European societal guidelines have endorsed PCI in patients with less-complex coronary disease while CABG still maintains a class I recommendation across all groups. The data to firmly establish the role of percutaneous treatment are currently lacking and the two on-going EXCEL and NOBLE trials will hopefully take us a step further in clarifying the role of PCI in the treatment of LMS disease.