Diabetes mellitus is a complex metabolic disorder with aggressive and progressive cardiovascular expression. This article reviews the main percutaneous techniques and their results in the diabetic population, from the early days of balloon angioplasty to the recently advent of drug eluting stents. As the latter devices may eradicate restenosis, plaque progression will remain the cornerstone for interventional cardiologists and the medical community. Attempts to modify life habits, and a more accurate control of the components of the metabolic syndrome should be the main therapeutic objective to slow down the progression and expansion of the disease.