Abstract： Objective To analyze the effects of paclitaxel-eluting balloon (PEB) and everolimus-eluting stent(EES) on coronary small vessel disease.Methods Totally 261 patients with small coronary artery disease (diameter≤2.5 mm) were enrolled from January 2015 to January 2016 in Beijing Anzhen Hospital,Capital Medical University;67 patients were treated by PEB (PEB group) and 194 patients were treated by EES (EES group).Coronary lesion was divided into focal lesion(length≤ 10 mm) and non-focal lesion(length ＞ 10 mm).All patients were followed up for 12 months;the primary endpoint event was target lesion revascularization(TLR);the secondary endpoint events included major adverse cardiac events(MACE),TLR,nonfatal myocardial infarction and all cause death.Results Duration of dual antiplatelet treatment in PEB group was significantly shorter than that in EES group [(4.6 ± 1.1) months vs (11.7 ± 2.1) months] (P ＜ 0.01).Incidences of TLR and MACE showed no significant differences between PEB group and EES group [9.0％ (6/67) vs 10.8％ (21/194),10.4％ (7/67) vs 12.3％ (24/194)] (P＞0.05).In patients with focal lesion,incidences of TLR and MACE in PEB group were significantly lower than those in EES group[4.2％ (1/24) vs 14.3％ (8/56),4.2％ (1/24) vs 16.1％ (9/56)] (P ＜ 0.05).In patients with non-focal lesion,incidences of TLR and MACE had no significant differences between PEB group and EES group[11.6％ (5/43) vs 9.4％ (13/138),14.0％ (6/43) vs 10.9％ (15/138)] (P ＞ 0.05).Conclusion PEB is more effective than EES in treatment of small coronary artery disease and it can shorten the duration of dual anti-platelet treatment.