Background A 38 mm TAXUS Liberte짰 Paclitaxel-Eluting Stent (PES) is one of the longest available drug-eluting stents (DES) for diffuse long lesion and can reduce the number of stents, costs and simplifying procedures. However, whether the long term outcomes of single38 mm PES is superior to those of multiple overlapping Sirolimus-Eluting Stent (SES) is not reported yet. Methods A total of 2061 patients (pts) who underwent PCI with DES in Korea University Guro Hospital from April 2003 to September 2009 were enrolled. The pts were divided into 2 groups: single 38 mm PES (n=30 pts) and multiple overlapping SESs (n=68) groups. Angiographic outcomes at 6 months and cumulative major clinical outcomes up to 24 months were evaluated between two groups. Results Baseline clinical and clinical characteristics were balanced between the two groups except single 38 mm PES group had higher incidence of diabetes mellitus (48.4% vs 10.3%, p<0.001), diffuse lesion (68.5% vs 56.1%, p=0.023), and more left circumflex artery lesion (32.9% vs 18.8%, p=0.021), whereas multiple overlapping PES group had higher incidence of left anterior descending artery lesion (41.1% vs 55.9%, p=0.040). Six month angiographic outcomes showed that single 38 mm PES group had higher restenosiss %, and lower minimal luminal diameter. However, major clinical outcomes including death, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR) and major adverse cardiac events (MACE) up to 24 months were similar between the two groups (Table). Conclusion In our study, despite the pts with diffuse long lesion treated with single 38 mm PES had higher restenosis % and lower minimal luminal diameter at 6 months than pts with multiple overlapping SES, this was not translated into worse clinical outcomes up to 24 months, suggestive of cost-effectiveness of single 38mm stenting.