Background: Chronic total occlusion (CTO) intervention is still challenging because of the limited procedural success rate and higher target failure. It is not clear whether the left anterior descending artery (LAD) lesion will significantly impact on angiographic and clinical outcomes in patients (pts) with CTO treated with drug eluting stents (DES) compared with those of non-LAD lesions. Methods: A total of 225 pts underwent CTO intervention with DESs were divided according to the different target CTO lesions (LAD CTO: n=86 pts, non-LAD CTO: n=126 pts). Six-month angiographic and twelve-month clinical outcomes were compared between the two groups. Results: The baseline clinical characteristics were balanced. The overall procedural success rate was similar between the two groups (95.9% vs. 94.0%, p=0.543). Procedural characteristics and procedure related complications including perforation and dissection were not different between two groups. Both groups had similar six months angiographic outcomes and clinical outcomes up to 12 months except that cardiac death was higher in the LAD CTO group (Table). However, after multivariate analysis, LAD CTO was not an independent predictor of cardiac death (OR: 4.971 CI: 0.313-1.982, p-value: 0.996). Conclusions: The safety profile and mid-term angiographic and clinical outcomes were similar between the two groups except higher incidence of cardiac deaths in the LAD CTO group. Long-term follow up with larger population will be necessary to get final conclusion.