Background: Balloon Catheter for AngioSculpt Scoring being considered using a scoring balloon close to the distal tip, cut the percutaneous transluminal coronary angioplasty (PTCA) catheter. The balloon is designed to expand to a specific diameter and length at a particular pressure. At the distal end of the catheter, there is a conventional nylon-blend balloon and a nitinol scoring element with three spiral struts that wrap around the balloon. Objective: To evaluate the outcome of using Angiosculpt in bifurcation and osteal lesions beside its efficacy and safety. Patients and Methods: This prospective, observational, non-controlled study included 20 with ischemic heart disease (IHD) patients, ischemic with osteal lesions and bifurcational lesion admitted at Wadi Elnil Hospital from January 2019 to May 2020. All patients were subjected to demographic data analysis, clinical examination, ECG. Echocardiography was done for each patient, on admission. Quantitative coronary angiography and PTCA using AngioSculpt then Percutaneous coronary intervention (PCI) with drug-eluting stent (DES) were performed. All patients received proper medications with follow up for morbidity and mortality for 3 months. Results: Mean age was 55± 23 years and 65% were men. The type of lesion was osteal in 25% of lesions and true bifurcation lesion in 75%. Additional stenting was performed in all lesions after angioplasty with the AngioSculpt balloon. The immediate complication was recorded as perforation in one patient (5%). Coronary complication was localized dissection, which was identified in one patient (5%). Survival was 100% at 6 months. Major adverse cardiac events (MACE) occurred in 10%of patients. Target lesion revascularization (TLR) was not needed at the study group. Conclusion: Using the AngioSculpt scoring PTCA balloon for osteal lesions and bifurcation lesion is considered to be safe and effective and leads to satisfactory clinical and angiographic outcome.