Trifurcating coronary artery disease is a complex atherosclerotic process involving the origin of one or more of three side branches arising from a left main coronary artery. With the emergence of drug-eluting stents, interventional cardiologists have become more aggressive in treating this kind of complex diseases, also in patients with an unprotected left main disease. Few series of percutaneous coronary intervention (PCI) on significant lesions of the left main trifurcations have been described, approached with dissimilar techniques in the best attempt of avoiding life-threatening complications. We therefore describe a case of successful PCI on a left main trifurcation supported by pre-and post-intravascular ultrasound iconography.