Objectives: The aim of this study is to know the angiographic and clinical outcome of final kissing balloon angioplasty (KBA) after stent implantation at main vessel only in the treatment of coronary bifurcation lesions with drug-eluting stent (DES). Methods: Between January 2004 and December 2006, a total of 364 patients who underwent drug-eluting stent implantation only for the main vessel of coronary bifurcation lesions were analyzed according to the performance of final KBA: Group I: no final KBA (n=264, 173 males); Group II: final KBA (n=100, 75 males). I performed post KBA if the Thrombolysis In Myocardial Infarction (TIMI) flow of side branch was reduced grade 0 or 1, or when the ostium of side branch become jailed more than 90% after stenting the main vessel. We evaluated the major adverse cardiac events (MACE) : death, non-fatal myocardial infarction (MI), target vessel revascularization (TVR) and target lesion revascularization (TLR) at three-year follow-up. Results: Final TIMI flow of the side branch was significantly decreased in the group I (15% vs. 4%, p=0.007). The fluoroscopic time and amount of contrast media were significantly less in the group I than in group II during coronary bifurcation intervention (25.8 짹 13.9 vs. 32.8 짹 10.5 minutes, p<0.001, 187.4 짹 52.6 vs. 204.7 짹 46.7 ml, p=0.024). There were no significant differences in the incidences of cardiac death (1.1% vs. 0%, p=0.380), MI (1.9% vs. 1%, p=1.000), TLR (5.3% vs. 8%, p=0.332), TVR (7.6% vs. 9%, p=0.667), and MACE (9.8% vs. 10%, p=0.552) between the two groups. Conclusion: Unless the TIMI flow was reduced grade 0, 1, or become jailed more than over 90% of side branch after stenting the main vessel in the bifurcation lesions, final KBA did not reduce the clinical outcomes during three-year clinical follow-up.