Introduction: The iodinated contrast media used in coronary angiography have a very low incidence of adverse effects. In cases in which adverse effects occur, other contrast media are necessary as an alternative. Gadolinium is one of these alternatives, as its safety has been demonstrated in patients with renal failure. However, gadolinium has important limitations, such as low radiopacity for the characterization of the coronary arteries and the need to administer low doses (<0.4 mg/kg) to reduce serious complications, such as nephrogenic systemic fibrosis. Materials and Methods: We present the first case series of patients undergoing percutaneous coronary intervention in which gadolinium was used as contrast medium and the procedure was guided by IVUS Results: We report the experience of our center, based on three patients with contraindication to iodinated contrasts who underwent IVUS-guided percutaneous transluminal coronary angioplasty using gadolinium and did not present with significant complications. Discussion and Conclusions: In cases where percutaneous coronary angioplasty is performed, high contrast doses are usually required. Intracoronary diagnostic techniques such as intravascular ultrasound (IVUS) can help reduce the contrast dose and provide great advantages during the intervention, improving the results.