The management of coronary artery disease (CAD) is evolving with the incorporation of drug-coated balloons (DCBs) as a pivotal technology. This approach, particularly beneficial for patients at high bleeding risk (HBR), offers a novel paradigm in the treatment of CAD by delivering antiproliferative medications without the need for permanent metallic implantation. The chapter delves into the historical perspectives of percutaneous coronary intervention (PCI), from bare-metal stents (BMS) to drug-eluting stents (DES), and the emergence of DCBs as a potential alternative. The chapter provides an in-depth analysis of DCBs from technical perspectives, detailing their mechanism, application, and the clinical scenarios where they are most effective. Furthermore, highlighting the advantages of DCBs, including the reduction in the necessity for prolonged dual antiplatelet therapy (DAPT) and associated bleeding risks, this narrative underscores the significance of DCBs in contemporary practice, especially for the HBR patient cohort.