Abstract: Presently coronary artery disease is considered as one of the major causes of mortality. The development of interventional cardiovascular technique such as coronary stunting has revolutionized the practice of interventional cardiology by overcoming partly some of the limitations of coronary angioplasty. During this procedure it produces vessel injury and induces thrombin generation and platelet activation with intertwined pathways, therefore Percutaneous Coronary Intervention (PCI) without anticoagulation appears unrealistic. It is almost universally accomplished with unfractionated heparin but the narrow risk-benefit ratio has led to search for better alternatives. The superiority of Low Molecular Weight Heparin (LMWH) over Un-Fractionated Heparin (UFH) is clear for ACS. Generally, the registries have reported a trend towards increased bleeding complications with LMWH than with UFH during PCI. In spite of its limitations, UFH proved to be the standard heparin therapy during PCI. This review study highlighted that LMWH requires further studies to determine their peri-catheterization monitoring, efficacy and safety profile.