Background The selection of percutaneous coronary intervention (PCI) regimen for patients undergoing elective tumor surgery with coronary heart disease(CHD) remains controversial. To evaluate the effectiveness and safety of using Drug Eluting Balloons (DEB) in study patients. Methods A retrospective study was conducted on 127 patients undergoing elective tumor surgery with CHD who received preoperative PCI treatment at the Fourth Hospital of Hebei Medical University from January 2022 to May 2023. According to the PCI treatment plan, it is divided into Drug Eluting Balloons (DEB) group (n = 61) and Drug Eluting Stents (DES) group (n = 66). The primary endpoints of follow-up were all-cause mortality and major adverse cardiac events (MACE), while the secondary endpoints were bleeding and Venous thrombotic events. Compare the incidence of all-cause mortality events, MACE, bleeding and Venous thrombotic events between two groups of patients during the perioperative period and 1-year after the surgery. Results During perioperative period, no all-cause death occurred in both groups. MACE in DEB group was lower than that in DES group (9.8%VS.27.3%, P = 0.012). For Confirmed the overall treatment time and Interventional-surgical time, DEB group was shorter than DES group(108[60,155]VS.218[170, 320],P< 0.001),(80[45.5,120]VS.210[168,300], P< 0.001). During the follow-up period, there were all-cause mortality (3.3%VS.13.6%, P = 0.038), MACE (9.8%VS.24.2%, P = 0.032)in the DEB and DES groups. Conclusions The results of this retrospective study showed that the all-cause mortality and MACE in patients were significantly lower than those in the DES group. DEB can also shorten the Interventional-surgical time, thus greatly reducing the overall treatment time.