Abstract : Angiography possesses limitations in assessing plaque composition, vessel width, diffuse reference vessel disease, lesion severity, and the success or failure of stent placement. Intravascular ultrasonography (IVUS) helps address several of these issues by offering enhanced visualization of the coronary architecture and stent placement. Study was conducted in AIIMS - Rishikesh, Department of Cardiology. Spanned 12 months with a 6-month follow-up. Post-angiography guided angioplasty and stenting. All patients underwent IVUS pullback. The study included 16 patients due to the non-working of the unspecified surgical package under the Ayushman Bharat scheme, with an intended target of 30 patients. Half of the patients (8, 50%) presented with acute coronary syndrome, while the other half presented with chronic stable angina. Left main disease was present in 50% patients, and 13 (81.25%) had complex coronary artery lesions. After angiography guided angioplasty, IVUS pullback on all patients, revealed that only three patients (18.75%) required post IVUS optimization of stent. The majority of patients did not require post-IVUS optimization following angiography-guided angioplasty and stenting. No major adverse cardiovascular events were recorded, and no target vessel myocardial infarction, target vessel revascularization, target lesion revascularization, or stent thrombosis were reported over the 6-month follow-up period.