Background: Therapeutic management for isolated coronary stenosis involving the left anterior descending (LAD) or left circumflex artery (LCx) ostium is challenging. This is attributed to the unpredictable involvement of the distal left main (LM) coronary artery, as reported in a previous intravascular ultrasound (IVUS) study. Aims and objectives: To compare between stenting ostial left circumflex artery lesions (LCx) vs drug coated balloon as single center experience with impact on Major adverse cardiac events after 6 months.   Subjects and methods: This retrospective study was conducted at Cardiology Department, Zagazig University Hospitals. This study was done on 88 patients who were divided into 2 groups: Drug-coated balloon group: 44 patients and drug-eluting stent group: 44 patients. Result: Significant differences were found in left ventricular ejection fraction, previous PCI history, coronary dissection after Drug Coated Ballon Angioplasty (DCBA) post-intervention Minimal Lumen diameter(MLD) , acute lumen gain, target lesion revascularization and Major Adverse Cardiac Events(MACE), Highly significant differences were observed in maximum pre-dilation balloon diameter, Drug coated  ballon /Drug Eluting Stents (DCB/DES) length and number, inflation pressure, follow-up MLD, and late lumen loss. Conclusion: DCB was connected with lower long-term risks of Target Lesion Revascularization(TLR) and MACEs. It is suggested that use of the DCB strategy alone or usage of the hybrid strategy is safe and effective for the treatment of de novo ostial LCx lesions with a low technical threshold and a high success rate.