Percutaneous coronary intervention (PCI) is associated with a lower 5-year stroke rate than CABG surgery in patients with multivessel and left main coronary artery disease, according to a pooled analysis of individual patient data from 11 randomized clinical trials including a total of 11,518 patients. The lower 5-year risk of stroke with PCI than with CABG surgery (2.6% versus 3.2%; HR 0.77) was driven by a reduced risk of stroke in the 30-day post-procedural period (0.4% versus 1.1%; HR 0.33). The risk of stroke between 31 days and 5 years was similar with both procedures, and the higher risk of stroke after CABG surgery was confined to patients with multivessel disease and diabetes mellitus. With either PCI or CABG surgery, patients who had a stroke within 30 days of revascularization had a higher risk of dying within 5 years than those without a stroke.