The impact of late stent malapposition(LSM) after drug-eluting stent(DES) implantation on late clinical events after cessation of dual antiplatelet treatment is unknown. We evaluated major adverse cardiac events [MACE: cardiac death, acute myocardial infarction due to late stent thrombosis, and target lesion revascularization(TLR)] in 547 patients (693 native lesions) in whom intravascular ultrasound(IVUS) was performed at index and six-month follow-up. LSM occurred in 80 patients with 83 lesions(11.5%). The duration of clinical follow-up beyond the six-month angiogram and IVUS was 32짹6 months in LSM and 31짹6 months in non-LSM(p=0.27). The duration of follow-up after cessation of dual antiplatelet therapy was 27짹9 months and 27짹8 months, respectively (p=1.0). Cardiac death occurred in one LSM(1.3%), and acute myocardial infarction due to late stent thrombosis occurred in one LSM(1.3%); cardiac death occurred in two non-LSM(0.4%), and acute myocardial infarction due to late stent thrombosis occurred in two non-LSM patients (0.4%) (p=0.2). TLR was necessary in one LSM patient (1.3%) and in eight non-LSM (1.7%) patients (p=0.6). There were no significant difference in overall MACE (3.8% versus 2.6%, respectively, p=0.4) (Figure); and LSM was not an independent predictor of long-term MACE events. In conclusions, LSM after DES implantation was not associated with MACE during the subsequent clinical follow-up of 31-months after the six-month angiogram and IVUS, and 27 months after cessation of dual antiplatelet treatment.