The use of drug eluting stents (DES) has reduced in-stent restenosis though preventing not only recoil of the vessel wall and late nega‌tive remodeling, but also significantly inhibiting neo-intimal hyperplasia formation. To evaluate the clinical efficacy, outcomes and safety of a drug-eluting balloons for the treatment of de novo coronary artery lesions and To compare the safety and efficacy of the DEB with the outcomes of DES in patients presenting for elective PCI for stable De novo coronary artery lesions. This study included 50 patients whom are being admitted to Kobry El-kobba military hospital for treatment of coronary de novo lesions. Out of the fifty patients included in our study, only three patients (6%) had positive MPI. Patients with positive MPI had higher age than those with negative MPI [66+-4.5 versus 56.3 +-7.7 years respectively] (P= .037). In addition, there was a tendency to get positive results with the smaller vessel diameters [mean vessel diameter was 2.50] compared to the wider diameters [mean vessel diameter was 2.64±0.125] in those with negative but this still not statistically significant (P= .054). A DEB-only strategy may show comparable short-term results in a mixed clinical patient population with de novo lesions in coronary vessels less than 2.8 mm in diameter. Despite the higher number of complex patients in our study, we could not prove the superiority of DEB over DES by the use of non-invasive imaging together with the clinical follow up.