Coronary artery calcification enhances percutaneous treatment complexity, increasing the likelihood of procedural failure and complications and affecting acute and long-term outcomes. In order to deal with such lesions, several devices and technologies, including balloons, atherectomy and intravascular lithotripsy, have been developed. The combination of the aforementioned technologies and the guidance of intracoronary imaging can help skilled interventional cardiologists in achieving better acute and long-term results in this setting. The purpose of the present review is to provide an appraisal of the devices dedicated to the treatment of calcified lesions, including the description of components and function and how to integrate them into a practical, standardized approach.