Background: Whether uric acid is a predictor of cardiovascular events remains controversial. We sought to evaluate the impact of serum uric acid levels on long-term major adverse cardiovascular event (MACE) in patients with coronary artery disease (CAD). Subjects and Methods: The study population, consists of 1393 consecutive patients with CAD, was followed up a mean of 40.7 months (maximum 126 months). Recorded MACE included death, acute myocardial infarction, stroke, coronary artery bypass surgery, percutaneous coronary intervention (PCI) due to de novo lesion during follow up, restenosis, target lesion revascularization, hospitalization for congestive heart failure and peripheral artery disease. Results: Patients (n=698) with high serum uric acid (���4.87mg/dL, mean 6.21짹1.19mg/dL) were likely to be male (67.5% vs. 41.7%, p<0.001), higher prevalence of hypertension (52.3% vs. 46.0%, p=0.020), smoking (33.9% vs. 25.3%, p<0.001), lower ejection fraction (63.8% vs. 65.7%, p<0.001), higher level of serum triglyceride (189mg/dL vs. 160mg/dL, p=0.001), lower HDL-cholesterol (41.8mg/dL vs. 43.3mg/dL, p=0.014), higher homocysteine (11.82mg/dL vs. 9.80mg/dL, p<0.001), higher Hs-CRP (0.26mg/dL vs. 0.21mg/dL, p=0.006), higher creatinine (1.12mg/dL vs. 0.91mg/dL, p<0.001) and more use of statin (55.2% vs. 49.0%, p=0.022) than those (n=695) with low serum uric acid (<4.87mg/dL, mean 3.86짹0.78mg/dL). In univariate analysis, patients with high uric acid level had higher chance of PCI and total MACE compared than those with low uric aicd level. Multivariate Cox regression analysis showed that the independent predictors of total MACE were no statin use (HR 2.127, 95% CI 1.540 to 2.936, p<0.001), low ejection fraction (HR 1.584, 95% CI 1.173 to 2.138, p=0.003), and low HDL-cholesterol (HR 1.448, 95% CI 1.072 to 1.956, p=0.016), and hypertension (HR 1.404, 95% CI 1.043 to 1.889, p=0.025). The independent predictors for PCI were high serum uric acid level (HR 1.882, 95% CI 1.065 to 3.326, p=0.030), no statin use (HR 2.858, 95% CI 1.595 to 5.123, p<0.001), and low ejection fraction (HR 1.768, 95% CI 1.063 to 2.941, p=0.028) Conclusion: Serum uric acid level is associated with subsequent cardiovascular events (especially PCI) in patients with CAD.