Hard, calcified, unyielding coronary artery lesions have been a major impediment to percutaneous interventions from the beginning. Technology to cope with this problem has developed so that, now, most of these lesions can be treated, optimal stent deployment can follow, and positive outcomes can be achieved. I say, “can be achieved,” but are they always achieved, and if so, how? Operators around the world have taken different approaches to address this problem. Some love rotary ablation, others abhor it and prefer very-high-pressure balloon dilatation. Some rely on cutting or scoring balloons or lasers, and many try multiple devices. Recent US Food and Drug Administration (FDA) approval of Shockwave coronary intravascular lithotripsy has sparked renewed interest in finding the best ways to treat these lesions. Lithotripsy differs from the other technologies in that it is designed to send shockwaves from within a balloon to fracture the calcium deposits in the wall of the artery. This mechanism, well-known for breaking up kidney stones, is a similar concept to the jackhammer that uses pulsatile force to break up concrete. There are no published randomized trials of this technology compared to other methods of treating heavily calcified coronary lesions, but there is a good deal of enthusiasm for the technology.