Drug-coated balloons (DCBs) provide a stent-free alternative, reducing risks like stent thrombosis and in-stent restenosis and the need for prolonged dual antiplatelet therapy. Recent studies show that DCBs can be effective and safe across various coronary artery diseases (CADs) when lesions are adequately prepared. Specifically, all coronary lesions are treated using the provisional approach, where active lesion preparation is followed by DCB or drug-eluting stent treatment, depending on the results. This approach means DCB is considered the default device before initiating intervention, with efforts focused on obtaining adequate lesion preparation. Depending on the result, DCB or drug-eluting stent is selected, which is termed DCB-based percutaneous coronary intervention. Therefore, this second report of the Asia-Pacific Consensus Group provides practical guidelines (DCB-based percutaneous coronary intervention) based on the latest evidence for DCB treatment in CAD and aims to expand its application across various CADs, facilitating its effective use in real-world clinical practice.