The optimal revascularization strategy for patients with coronary artery disease is influenced by the continuous improvement in medical therapy and the improved designs of the new generation of coronary stents allowing them to be increasingly applied in patients with complex coronary anatomy, including those with left main stem disease. On the other hand, surgical results are also improved as a result of the increased experience over years and the improvement of myocardial protection techniques. This will make the comparison of percutaneous coronary interventions and coronary artery bypass surgery a moving target. In this paper, we reviewed the recent randomized controlled trials and important registries emphasizing the benefits and the results of each therapy in different patient subsets. A heart team of both cardiologists and cardiac surgeons is of paramount importance in choosing the optimal revascularization strategy.