AbstractTrifurcation lesions, especially around the left main coronary artery (LMCA), are occasionally encountered. Complex lesions, involving the bifurcation or the trifurcation of the unprotected LMCA, represent a real challenge for interventional cardiologists. Trifurcation lesions intervention reported to have high overall major adverse cardiovascular events, and require the use of various complex interventional techniques, for example, large guiding catheters to accommodate three wires guiding simultaneously inflated balloons or stents. Here, we report a case of successful percutaneous coronary intervention supported by pre‐and post‐intravascular ultrasound imaging, on an LMCA trifurcation using a 6F guiding catheter via transradial approach. © 2010 Wiley‐Liss, Inc.