The treatment of calcified coronary artery lesions remains a significant challenge in percutaneous coronary intervention (PCI). Heavy calcification often results in poor stent expansion, incomplete lesion preparation, and increased procedural complications. Intravascular lithotripsy (IVL) is an innovative technology that uses sonic pressure waves to fracture calcified plaques, facilitating optimal stent deployment. This review explores the mechanism of IVL, clinical evidence, safety profile, and its potential role in modern PCI practice.