Objectives: To identify predictive factors of long-term outcomes after crush technique for bifurcation coronary lesions. Background: The long-term outcomes and its predictive factors after crush technique for bifurcation lesions remain uncertain. Methods: Consecutive 273 patients with 278 bifurcation lesions who received crush stenting were prospectively enrolled. Final kissing balloon dilatation (FKBD) after crushing was attempted in all patients. Guidance of intravascular ultrasound was attempted in all procedures. Angiographic analysis was performed using the dedicated bifurcation software. Analysis was performed per a lesion basis. Results: FKBD was successfully performed in 94.2% of lesions and non-compliant balloon was used in 45.3% for the main branch and 36.7% for the side branch. For the median of 18 months follow-up, major adverse cardiac events (MACE) including death, myocardial infarction, and target vessel revascularization (TVR) occurred in 21 lesions. Freedom from death, myocardial infarction, TVR and MACE were 97.0%, 96.3%, 83.7% and 80.4%, respectively. Angiographic follow-up was performed in 72.7% of lesions and angiographic restenosis was identified in 9.4% of lesions. In multivariate Cox model, diabetes mellitus FKBD and pre-procedure MLD at proximal main branch were independently associated with MACE. Conclusions: Crush technique under the guidance of intravascular ultrasound has favorable long-term outcomes when FKBD is successfully performed.