The prevalence of coronary artery calcification (CAC) related to obstructive coronary artery disease (CAD) is rising due to the increasing burden of comorbidities associated with vascular calcification.  Percutaneous coronary intervention (PCI) of calcified coronary lesions is associated with lower procedural success and increased risk for both early and late complications as coronary calcification can impede stent delivery and deployment, lead to stent underexpansion and malapposition, and directly damage stents. Intravascular imaging is increasingly recognized as an intraprocedural tool that can identify the extent, phenotype, and location of calcium in the target coronary artery and guide use of calcium modification strategies that may lead to optimal stent deployment with a decreased risk of adverse events.  There is a growing number of adjunctive devices to facilitate PCI in calcified lesions, including specialty balloons, atherectomy devices, and intravascular lithotripsy (IVL). Given the increasing prevalence of calcified CAD, the expanding role of intravascular imaging during PCI of calcified CAD, and the expanding portfolio of treatment devices available, the Society for Cardiovascular Angiography & Interventions (SCAI) has developed an expert consensus statement to address the treatment of calcified coronary lesions.