Drug-coated balloons (DCBs) have emerged as a potentially useful tool in our armamentarium for preventing restenosis following hemodialysis access angioplasty. Given that restenosis is such a prevalent problem in this patient population, anything that can convincingly improve the results of angioplasty is bound to receive a warm reception from the interventional community. To date, the evidence in favor of DCBs, which continues to mount, has outweighed the negative results; however, there continues to be equipoise, as demonstrated by conflicting conclusions in systematic reviews.