Background: Compared with bare metal stents (BMSs), drug-eluting stents (DESs) have been shown to significantly reduce the rate of major adverse cardiac events, especially when used in vessels smaller than 3 mm or bypass grafts. This study compared clinical outcomes of DESs versus BMSs in large coronary arteries (> or = 3.5mm) without long lesions (< 25mm). Methods and Results: A total of 1,340 patients with acute myocardial infarction (AMI) who underwent single-vessel PCI in large coronary arteries (>=3.5mm) between Nov. 2005 and Sept. 2006 were divided into two groups: group I: patients who received BMSs, N=189 and group II: patients who underwent DES implantation, N=1,151. Clinical outcomes at 30 days and six months were compared between groups. Baseline clinical and procedural characteristics were similar. Stent diameter was significantly greater in the BMS group (BMS group: 3.58짹0.27mm, DES group: 3.98짹0.44mm, p < 0.0005) and stent length was significantly greater in the DES group (BMS group: 20.4짹3.42mm, DES group: 19.5짹3.60mm, p = 0.002). At 30 days, there were one cardiac death (0.8%), one AMI (0.8%), one target lesion revascularization (TLR, 0.8%), and one non-target lesion revascularization (non-TLR, 0.8%) in the BMS group, but no significant difference existed between the two groups (p = 0.152). At six months, the primary outcome occurred in 8.0% of patients with BMSs (N=6: one cardiac death, one non-cardiac death, one AMI, and three TLRs) and 4.4% of patients with DESs (N=17: two non-cardiac deaths, six TLRs, eight non-TLRs, and one coronary artery bypass grafting), but there was no statistical difference between the two groups. Conclusion: Clinical outcomes of BMSs were comparable with those of DESs in patients with AMI who underwent single-vessel PCI in large coronary arteries without long lesions.