Background: Drug-coated balloons (DCBs) have become an important endovascular technology for peripheral artery disease, particularly femoropopliteal disease. They deliver antiproliferative medication to the vessel wall without leaving a permanent implant.

Objective: To review the role, outcomes, advantages, limitations, and future directions of drug-coated balloons in peripheral vascular interventions.

Methods: This narrative review summarizes contemporary clinical evidence, device principles, lesion selection, procedural techniques, safety concerns, and post-procedural management.

Results: DCB therapy improves vessel patency and reduces restenosis compared with plain balloon angioplasty in selected peripheral lesions. Outcomes are strongest in femoropopliteal disease, while evidence continues to evolve for below-the-knee, dialysis access, and complex calcified lesions.

Conclusion: Drug-coated balloons are valuable tools in peripheral vascular intervention, especially when avoiding permanent stent implantation is desirable. Optimal outcomes depend on lesion preparation, appropriate patient selection, and careful follow-up.