Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) have undergone substantial technological advances, and revascularization is an established therapeutic option in the treatment of coronary artery disease (CAD). Here we focus on optimization of decision making in revascularization strategies, as is being addressed in recent large clinical trials and the guidelines issued by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS).