In this CAMP at TCT exclusive case review, Paul Teirstein, MD, Jonathan Hill, MD, and Allen Jeremias, MD, discuss the importance of intracoronary imaging when treating severely calcified lesions. Dr. Teirstein discusses rotational and orbital atherectomy, Dr. Hill discusses intravascular lithotripsy (IVL), and Dr. Jeremias focuses on intravascular ultrasound (IVUS) and optical coherence tomography (OCT).