Background Little is known about the impact of late bleeding after drug-eluting stent (DES implantation). Methods Using a time-updated Cox model, the impact of bleeding and myocardial infarction (MI) on 3-year mortality was analyzed in 3,148 consecutive patients who underwent DES implantation for coronary disease. Results Bleeding, defined according to STEPPLE minor or major criteria, occurred in 6.5% of patients over 3 years. Patients with bleeding were older, were more likely to be female, had higher rates of diabetes mellitus, hypertension, extensive coronary disease, and lower ventricular function, and underwent more complex procedures than those without bleeding. The 3-year mortality rate was significantly higher for patients with bleeding than those without bleeding within 30 days (18.7% vs. 3.7%, p<0.001) and after 30 days (19.6% vs. 3.0%, p<0.001) post-procedure. The 3-year adjusted hazard ratios (HRs) for mortality were shown in the figure. When the timings of events were separated, the HRs for mortality were 4.89 (95% CI, 3.08–7.78; p<0.001) and 7.81 (95% CI, 4.39–13.89; p<0.001) for patients with bleeding within and after 30 days, respectively. By contrast, the HRs for mortality were 1.85 (95% CI, 1.09–3.14, p=0.022) and 10.33 (95% CI, 4.91–21.75, p<0.001) for patients with MI within and after 30 days, respectively. Conclusions Bleeding is closely associated with mortality during both the early and late periods after DES implantation. Therefore, in addition to carefully assessing bleeding after stenting, evidence-based treatment should be implemented to offer the best balance of benefit and harm.