Diabetes mellitus has reached epidemic proportions and is associated with decreased event-free survival following coronary revascularization. Although the historical complication rates for diabetic patients following percutaneous coronary intervention have been less than acceptable, the emerging drug-eluting stent technology when coupled with an aggressive adjunctive pharmacological regimen will improve the complication rates following percutaneous revascularization for this high-risk group of patients. This review will focus on the historical data associated with revascularization, percutaneous and surgical, and diabetes mellitus and will highlight the emerging data of drug-eluting stents and adjunctive pharmacology.