Background: The purpose of the study is to compare neointimal hyperplasia and peristent arterial remodeling after implantation of everolimus-eluting stent (EES) versus sirolimus-eluting stent (SES) using IVUS. Methods: The study population was a subgroup of 278 patients from the EXCELLENT trial, a randomized study comparing EES and SES for the treatment of de novo native coronary artery lesions (total n=1,400, 3:1 randomization) who underwent post-PCI and 9-month follow-up IVUS investigation. There were 209 patients in the EES group and 69 patients in the SES group. Results: Baseline clinical and angiographic characteristics were similar between the two groups except for higher age in the EES group (60.8 짹 9.9 vs. 64.5 짹 8.4, p=0.006). At 9 months, percent neointimal volume obstruction did not differ between EES and SES (2.6짹4.0% vs. 2.5짹4.8%, p=0.814). However, the change in plaque+media (P&M) volume (3.72짹17.28% vs. 10.70짹22.14%, p=0.017) within the stented segment was smaller with EES versus SES (6.8 짹 33.1 vs. 18.2 짹 41.1 mm3, p=0.021). There was also a trend toward smaller vessel volume change with EES vs. SES (15.3 짹 54.2 vs. 28.9 짹 67.3, p=0.091). In addition, positive persistent arterial remodeling defined as an increase in vessel volume >10% (27.8% vs. 42.0%, p=0.027) and late acquired stent malapposition (4.8% vs. 23.2%, p<0.001) were observed less frequently with EES versus SES. Conclusions: EES and SES were similarly effective in reducing neointimal hyperplasia. However, positive persistent arterial remodeling and late acquired stent malapposition occurred less frequently with EES.