Percutaneous treatment of coronary bifurcation lesions has historically been associated with an increased risk of both periprocedural and longer-term adverse events, making optimal stenting strategy a subject of continuous debate among the practicing clinicians. In the following chapter, we review the contemporary evidence base that constitutes the foundation for approaching coronary bifurcation lesions in clinical practice. The objective of bifurcation PCI is to respect and to ‘reproduce’ the natural coronary fractal anatomy, and stenting of the main vessel, with the provisional treatment of the side branch, is recommended default strategy for the majority of coronary bifurcations. Herein we present the main principles of the stepwise provisional strategy, including main vessel stent optimization techniques, such as proximal optimization technique (POT) and kissing balloon inflation in accordance with the European bifurcation club (EBC) consensus documents. Subsequently, the side branch treatment is discussed, from the perspective of the clinical importance of a side branch and based on the hitherto published randomized trials comparing provisional strategy versus upfront double stenting. In addition, clinical studies comparing different two-stent techniques and investigating the role of routine kissing balloon inflation are reviewed with regard to the implications of their findings for everyday clinical practice. Finally, a detailed overview of the technical aspects of the most commonly used two-stent techniques, such as T/TAP, Culotte and DK-Crush, according to EBC recommendations is provided. The chapter is concluded with a dedicated section on left main stenting, accompanied by an outlook on the role of intracoronary imaging for procedural guidance.