Background: Controversy exists over whether multivessel revascularization is effective in acute myocardial infarction (AMI) patients with multivessel coronary artery disease (MVD) in the drug-eluting stent (DES) era. We assessed the clinical impact of multivessel revascularization in Asian AMI patients. Methods and Results: A total of 4836 AMI patients who had MVD and had undergone percutaneous coronary intervention (PCI) with DES (multivessel PCI group: 1965 patients; culprit-only PCI group: 2871 patients) in the Korea AMI Registry (KAMIR) were analyzed. In-hospital and 1-year clinical outcomes were compared between the two groups. There were no significant differences in 1-year clinical outcomes, and the multivariate analysis adjusted by propensity score showed no significant differences in major adverse cardiac events, death, recurrent MI, or repeat PCI rate between the two groups. We also found no benefits of multivessel PCI in various clinical settings such as diabetes mellitus, elderly age, renal insufficiency, cardiogenic shock, and ST-segment elevation MI. Conclusions: We found no significant benefits of multivessel PCI using DES in Asian AMI patients with MVD.