Backgroud: Transradial intervention (TRI) is drastically increasing because of the lower incidence of major bleeding and vascular complications compared with transfemoral intervention (TFI). However, there have been very limited data regarding clinical outcomes of TRI versus TFI in Asian population. Methods: A total 4215 consecutive patients (pts) from nine major hospitals were enrolled from January to December 2009. Angiographic outcomes and cumulative clinical outcomes up to six months were compared between TRI group (n=2639, 62.6%) and TFI group (n=1576, 37.3%). Results: Baseline characteristics showed that TRI group were younger and had higher incidence of dyslipidemia, prior percutaneous coronary interventioon (PCI), lower incidence of ST elevation myocardial infarction (STEMI) and non STEMI (NSTEMI) compared with those of TFI group. In-hospital complications showed that TRI group had lower incidence of cardiogenic shock, major and minor hemorrhage, transfusion and vascular complications compared with TFI group. In hospital and clinical outcomes up to six months showed that there was a trend toward lower incidence of cardiac death, and TLR & TVR-MACEs were lower in the TRI group (Table). Multivariate analysis showed that the TRI was an independent predictor of reducing TLR-MACE (Adjusted OR: 0.422, 95% CI:0.203-0.878, p-value<0.001) and TVR-MACE (Adjusted OR: 0.422, 95% CI: 0.265-0.858. p-value<0.001) at 2 years. Conclusions: In our study, TRI group was associated with lower in-hospital and 6 months TLR- and TVR-MACE as compared with those of TFI group. We suggest that TRI may play an important role in improving mid to long-term clinical outcomes of pts undergoing PCI with DESs.