Backgrounds; We examined the clinical and angiographical long-term outcomes of patients with coronary artery aneurysms (CAAs) associated with drug-eluting stent (DES) implantation. Methods; This retrospective study included all consecutive patients (n= 96) with CAAs (n=107) undergoing percutaneous coronary intervention-DES implantation (PCI-DES) at our institutions from April 2003 to September 2008. Clinical follow-up commenced from the point at which the CAAs was detected. Angiographical follow-up was performed in 44.9% (n=48) of cases after detection of CAAs and clinical follow-up was obtatined in 98.7% of patients. The mean clinical and angiographical follow-up period was 34.8짹13.1 months and 9.5짹11.3 months, respectively. Results; CAAs was composed of a saccular form in 31.6% (n=35), a fusiform in 14% (n=15), and microaneurysm in 54.2% (n=58). Of these cases, 12% (n=13) were associated with stent fracture. Among the cases (n=48) with angiographical follow-up, 18 CAAs showed no interval change, 9 CAAs became larger, 11 CAAs became smaller, and 10 CAAs disappeared. Major adverse cardiac event (MACE) rate at follow-up was 21.5% (n=23) including a mortality of 1.9% (n=2), MI in 7.5% (n=8), and TLR in 14% (n=15). Univariate analysis revealed that predictors for MACE were concomittent presence of stent fracture (p=0.003), stent length (p=0.04), and enlargement of CAA (p=0.05). Cox regression analysis showed that the independent predictors of MACE after CAAs were stent length (p=0.034), and DM (p=0.038). Dual antiplatelet therapy was not significantly associated with MACE after CAAs. Conclusion; The long-term course of CAAs was variable clinically and angiographically. We found that CAAs were frequently associated with MACE during follow-up of a mean of 34.8 months, especially in those with longer stent length, or DM. Further studies is required to delineate the exact course and optimal treatment of this disease entity