Treating bifurcation lesions is a challenge in interventional cardiology. There is evidence that the anatomic morphology of the lesions plays a role not only in procedural success and complication rates, but also in the selection of stenting technique. Bifurcation angle, assessment of lesion severity, and acute stent thrombosis all pose a challenge to the interventionist. Safety issues related to treatment of bifurcation coronary disease is discussed. Assessment of lesions both before and after stenting using intravascular ultrasound in addition to quantitative coronary angiography may result in fewer complications.