Although intravascular ultrasound has been used for decades, its common application in catheterization centres during coronary interventions is very rare and merely reaches few percents. The reason is the lack of randomized trials of its use and often few experiences in evaluation of ultrasound findings. Data based on meta-analysis of observational studies clearly demonstrated the positive effect on the most important parameters for the treatment of patients with ischemic heart disease, such as mortality and incidence of myocardial infarction after coronary interventions. Therefore, according to the latest guidelines for myocardial revascularization of the European Society of Cardiology is level of recommendation in category IIa for the use of intravascular ultrasound. IVUS continues to be an important part of new investigation methods which try to better describe coronary atherosclerosis. Particularly, it is the method NIRS (near-infrared spectroscopy) and other new methods of evaluating the composition and mechanical properties of plaque. These facts suggest that IVUS maintains its contribution in time of optical coherence tomography (OCT) and the emphasis put on the functional assessment of coronary stenoses.Key words: coronary atherosclerosis - intravascular ultrasound - percutaneous coronary intervention.