Coronary intravascular lithotripsy (IVL) for treating severe coronary calcification appears promising in the DISRUPT CAD III registry. 384 patients with were enrolled at 47 sites in U.S., U.K., France, and Germany. The results showed the primary safety (freedom from 30-day MAC) and primary efficacy (procedural success defined as successful stent delivery with a residual stenosis <50% without in-hospital MACE) endpoints were achieved in 92.2% and 92.4% of patients, respectively. Notably, no coronary perforations occurred in the trial. Transient IVL-induced ventricular capture was common but resulted in no clinical sequelae.