Background: Several risk factors of very late stent thrombosis (VLST) after drug-eluting stent (DES) implantation have been suggested. Few studies have examined the association between the stent-related variables and VLST. Methods: We analyzed 1618 patients (1718 lesions) who received DES implantation and had the opportunity of at least 2 years of follow-up from October 2003 to March 2005 in our institute. Patients with acute or late thrombosis were excluded. Results: During 32짹5 months of follow-up, VLST occurred in 33 patients (2.0%). Compared with no VLST group, patients group with VLST had longer lesions (35.2짹21.1 vs. 28.8짹15.8 mm; p=0.035) and longer stents (62.2짹43.6 vs. 49.2짹31.7 mm; p=0.021). Also VLST group had more stents per lesion (1.8짹1.0 vs. 1.4짹0.7; p=0.008) and longer stents per lesion (49.1짹28.1 vs. 38.5짹20.9 mm; p=0.014). By multivariate analysis, lesion length was the only independent predictor of VLST. Conclusion: Lesion length, stent length, and the number of stents per lesion were associated with occurrence of VLST. Lesion length was the only independent predictor of VLST.