There are several universal guiding catheters that can be engaged both for left and right coronary arteries. What is the benefit of a universal guiding catheter? First, it can reduce cost in case of PCI for both left and right coronary arteries. Second, it can reduce time by avoiding catheter exchange. However, in many situations, the PCI target is either the left or right coronary artery but not both. Taking a few minutes for catheter exchange does not usually matter except with ST elevation myocardial infarction (STEMI). Thus, some may debate whether to select a universal guiding catheter in routine PCI.