Background: Cerebrovascular disease (CVD) frequently coexists with significant coronary artery disease (CAD). We aimed to evaluate the impact of prior CVD on 1-year clinical outcomes in acute coronary syndrome (ACS) patients (pts) undergoing percutaneous coronary intervention (PCI) in drug-eluting stents (DES) era. Methods: A total of 1070 consecutive ACS pts underwent PCI with DESs were enrolled. Study population was divided into the prior CVD group and no prior CVD group. In-hospital complications and clinical outcomes up to 1 year were compared between the two groups. Results: Baseline clinical and procedural characteristics were similar between the groups, except higher incidence of elderly (68.97짹9.32 vs. 64.85짹11.45, P=0.007), hypertension (89.2% vs. 61.7%, P<0.001), peripheral vascular disease (12.3% vs. 1.0%, P<0.001) and calcified lesion (26.2% vs. 14.7%, P=0.02) in the prior CVD group. However, despite the in-hospital major adverse cardiac events (MACEs, P=0.103) and all other major clinical outcomes up to 1 year were numerically higher in prior CVD group, they did not reach to statistical difference (table). Conclusion: Prior CVD had no significant impact on 1 year major clinical outcomes in ACS pts underwent PCI with DESs in real world clinical practice.