Several new-generation percutaneous support devices are available or are in different stages of development for use in high-risk percutaneous coronary intervention (PCI), cardiogenic shock, and for other indications. Preliminary studies have demonstrated the feasibility and safety of these devices and the beneficial effect on hemodynamic parameters. In this article, the authors discuss (1) the percutaneous circulatory support devices presently available and routinely used in the catheterization laboratory, (2) the technical aspects involved with insertion and removal, and (3) relevant data from randomized trials, meta-analyses, and registries about the benefits of their use in patients with cardiogenic shock complicating ST segment elevation myocardial infarction and in those with significant left ventricular systolic dysfunction undergoing complex PCI.