Selection of the proper dilatation hardware in performing coronary angioplasty will facilitate the procedure, minimize its cost, and enhance its safety. Over the past 3 years, there has been an acceleration of growth in PTCA catheter and wire technology. We evaluated all currently approved dilatation systems as well as some investigational equipment and herein discuss their relative merits and disadvantages. To aid in operator selection of equipment, the concept of a risk: benefit ratio of potential for intimal trauma vs maximal back-up support is introduced. This information combined with objective data may be helpful in choosing the optimal dilatation equipment, which must be highly individualized for operator preferences and for each patient and his respective coronary anatomy.