Artificial intelligence (AI) can enhance various aspects of coronary angiography and structural heart interventions. Over the last 35 years, interventional cardiologists tried to make a computer-assisted quantification with angiogram, IVUS, and OCT images of coronary plaques to assess the degree of stenosis. As with computer tomography (CT), AI algorithms can optimize identification, characterization, and physiological assessment of coronary lesions and patient-specific risk profiles, thus improving procedural planning and predict postprocedural outcomes. During percutaneous structural heart interventions, AI can support real-time image analysis and decision-making, guiding complex procedures with increased accuracy and reducing the likelihood of complications. AI also can help refining clinical trial designs, patients’ selection, and enhancing trial efficiency. Looking to the future, AI is set to revolutionize device research and development by utilizing predictive modeling and simulations to expedite the creation of advanced cardiovascular devices. By integrating AI into the full spectrum of interventional cardiology—from procedural planning to device development—this technology not only enhances clinical efficacy but also encourages personalized medicine, ultimately improving patient outcomes and streamlining cardiovascular care.