Small-diameter stents play a crucial role in treating congenital heart diseases and variety of vascular conditions that have application from paediatrics to geriatric conditions, and a comprehensive review in this direction is lacking. This review explores historical development, design innovations, material compositions and mechanistic insights into functions of small-diameter stents, with a specific emphasis on biodegradable options. The necessity for stents that can adapt to growth of paediatric patients is discussed, highlighting the transition from durable polymers to bioresorbable materials such as polylactic acid (PLA) and magnesium alloys. While acknowledging the advancements made in reducing complications like restenosis and thrombosis, the review addresses the challenges that persist, including the need for improved biocompatibility and minimization of late adverse cardiac events associated with certain stent technologies. A detailed examination of various stent generations emphasizes the importance of drug release kinetics, structural integrity and potential for personalized interventions based on patient-specific factors. The exploration of novel therapeutic compounds, including nanoparticles and interfering RNA, illustrates the ongoing research aimed at enhancing stent efficacy. Ultimately, the review seeks to provide a comprehensive understanding of current landscape while identifying the gaps that future research must address to develop the ideal stent for diverse patient populations.