The relative outcomes of percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) in patients with multivessel coronary artery disease (MVD) have been debated for 3 decades. The essence of this discourse centers on the differential outcomes between these revascularization modalities in (1) procedural morbidity and mortality; (2) long-term protection from death, stroke, and myocardial infarction (MI); and (3) quality of life (including recurrent angina and repeated revascularization). Although numerous trials have evaluated PCI vs CABG in MVD, applying the average treatment effects from these studies to individual patients is challenging, and the rapid evolution of medical, interventional, and surgical approaches has lessened the relevance of these trials to contemporary decision making.