IntroductionStent thrombosis (ST) is a complication of percutaneous coronary intervention (PCI) with catastrophic clinical consequences and an incidence rate of 3% - 20% . Stent underexpansion and malapposition are the major causes of this complication that can be well-diagnosed and prevented by intracoronary imaging like intravascular ultrasound (IVUS) and optical coherence tomography (OCT) .This report presents a 60-year-old gentleman with a history of recent PCI on RCA (due to inferior NSTEMI). RCA stent thrombosis was diagnosed during staged PCI for LCX-OM which was successfully managed under the guidance of IVUS.