Background; Paclitaxel-coated balloon (PCB) was recently introduced as an alternative method for treatment of coronary in-stent restenosis, small coronary arteries, and bifurcation lesions. Methods; Recently we experienced 69 patients (71 lesions) treated by a PCB from September, 2009 to July, 2010 in Seoul St. Mary���s Hospital. We selected patients with either in-stent restenosis or de-novo coronary lesions, which encompass discrete lesion, vessel size < 2.5mm, and bifurcation lesion. We compared acute lumen gains between these groups. Results; We used 71 PCBs. Acute lumen gain for all interventions was 1.04짹0.61 (p<0.0001). Changes in lumen before and after ballooning were statically significant for both in-stent restenosis and de-novo lesion groups; however, acute lumen gain of in-stent restenosis group was larger than that of de-novo lesion group (1.20짹0.62 vs. 0.85짹0.54, p=0.02). PCBs in discrete lesion and vessel size < 2.5mm groups resulted significant acute lumen gains, but they were not different with those in long lesion and vessel size ��� 2.5mm groups respectively (0.74짹0.55 vs. 1.02짹0.51, p=0.09; 0.91짹0.47 vs. 0.82짹0.59, p=0.44). We also used a PCB in 3 patients with stenosis of coronary artery bypass graft anastomosis site regaining patent blood flow although its acute lumen gain was insignificant (0.92짹0.54, p=0.25). There were 9 procedural complications; 5 dissections, 3 no/slow reflow, and 1 failure. During clinical follow-up period (91.0짹73.6 day), there were no major adverse cardiac. Conclusions; PCBs in both in-stent restenosis and de-novo lesion groups demonstrated effective acute lumen gains with tolerable safety. Treatment using the PCBs may offer an alternative to the implantation of drug-eluting stents.