The mode of endovascular treatment for atherosclerosis obliterans of the lower limbs has evolved significantly over the last decade, from the initial percutaneous transluminal angioplasty (PTA) to stenting, and then to the implant-free surgery following the "leave nothing behind" concept that is represented by drug-coated balloon, plaque excision and laser erosion. In an attempt to overcome the stubborn problem of high restenosis rates after PTA and stenting, the attempts of using drug-coated balloon in treatment of atherosclerosis obliterans of the lower limbs have been started worldwide in the past five years and especially in China since June 2016, and favorable therapeutic results have been obtained. Here, the authors provide an overview of the rationale and the technology of DCB and review currently available data from randomized controlled trials.