Calculated lesions often mean percutaneous intervention outcomes are sub-optimal and increase the risk of procedural complications and future adverse events. Available plate-modifying devices rely on tissue compression or debulking to break down calcium and facilitate optimum stent deployment. Coronary intravascular lithotripsy, on the other hand, delivers unfocused, circumferential, pulsatile mechanical power to safely disrupt calcium within the target lesion. The current review summarises the evidence accessible to date for this therapy and includes a practical summary of the components and functions of the Shockwave Intravascular Lithotripsy System.