62 year old NIDDM male presented with CCS Class II angina and positive SPECT MPI for infero-lateral and apical ischemia. A Cardiac Cath on June 4, 2018 revealed 3 V CAD; CTO of mid RCA distal vessel fills via bridge collaterals, 95% proximal LAD, 90% proximal LCx with LVEF 60% and SYNTAX Score 28. After Heart Team discussion, patient opted for multi-vessel staged PCI. Patient underwent successful intervention of proximal LAD using DES (Xience Sierra 3.25 x 23) and proximal LCx using DES (Xience Sierra 3.25 x 18). Patient is now planned for staged PCI of RCA CTO using antegrade or retrograde approach.