Objective : Widespread utilization of DESs raises concerns with regard to risks of late thrombosis. Vessel diameter have been previously identified as predictors for restenosis for DESs and BMSs. This study compared the clinical outcomes of DESs versus BMSs in large coronary arteries. Method : A total 1,122 patients who was implanted with large stents (minimum stent diameter ���3.0mm even though multiple stenting), were included from July 2001 to July 2007 (DES in 1,116 lesions, BMS in 270 lesions). Major adverse cardiac events [MACE;cardiac death, myocardial infarction (MI), target lesion revascularization(TLR) and target vessel revascularization(TVR)] and rates of stent thrombosis (ST) were compared. Results : The median follow-up duration was 22 months. Baseline characteristics were similar except higher frequency of smoker and myocardial infarction in BMSs group. The incidence of MACE was significantly higher in BMSs group (17.7% vs. 7.4%, p<0.001). The incidences of cardiac death (3.0% vs. 2.6%), myocardial (2.6% vs. 1.5%), TVR (1.5% vs. 0.6%) and ST (3.0% vs. 3.7%) were not different. But the incidence of TLR was significant higher in BMSs group (11.1% vs. 2.7%, p<0.001). Kaplan–Meier survival curves showed the significant benefit of DES with regard to the rate of MACE (p<0.001). In 417 MI subgroup, the incidence of MACE was significantly higher in BMSs group (15.9% vs. 8.4%, p<0.001). The incidences of cardiac death, MI were not different. The incidence of stent thrombosis was higher in DES group but statistically insignificant (2.3% vs. 4.9%, p=0.2). But the incidence of TVR and TLR was significantly higher in BMSs group (2.1% vs. 0%, 9.7% vs. 1.4%, p< 0.001). Kaplan–Meier survival curves did not show the statistically significant benefit of DES with regard to the rate of MACE (p=0.064).Conclusion: Implantation of DESs even in large coronary arteries confers additional benefit compared with BMSs without increase of stent thrombosis. But in MI subgroup, MACE free survival was not different between both groups. The large scale randomized clinical study was needed for the evaluation of the safety and efficacy of DES use in large coronary artery, especially in myocardial infarction.