Backgrounds: The aim of this study was to evaluate the clinical and angiographic outcomes of sirolimus-eluting stent (SES) in the treatment of diffuse long lesions in the real word practice and 6 years long term clinical outcomes. Material and Methods: We implanted multiple SES (>40 mm in total length) in 113 de novo lesions in 113 patients. The average length of the implanted stents as 58짹14mm (41-112 mm) and 2.2 stents were implanted in each lesion and the average stent diameter was 3.0짹0.3 mm. Study endpoints were major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR) and stent thrombosis (ST) for 6 years after index PCI. Results: Procedural and angiographic success were achieved in all patients. After procedure, Non-Q wave MI (CK-MB���3 times normal value) was developed in 13 patients (11.5 %). A six months follow up angiography was performed on 76 patients (67 %) and angiographic binary restenosis was developed in 7 patients (9.2 %). All of them were focal type in-stent restenosis and found at the distal stents. Two patients (1.8 %) had a late ST at 12 months. There were two sudden cardiac death (1.8%), one non Q-wave MI (0.9 %) and six TLR (5.3%) at 12 months. Mean follow-up duration was 1684짹866 days. There were 4 sudden cardiac death (3.5 %), 7 non Q-wave MI (6.2 %), 6 STEMI(5.3 %), 14 TLR (12.4%), 20 TVR (17.7%), 2 CABG (1.8%), 2 late ST(1.8%) and 3 very late ST(2.7%). The major adverse cardiac events (MACE)-free survival was 94 % at 12 months, 83 % at 3 years and 73 % at 6 years. Conclusion: Long term clinical outcomes of patients with diffuse long coronary lesion treated SES for 6 years were acceptable in the ���real world��� practice. Key Words : Drug-eluting stent, MACE, long term follow up