Background: It is well established that the older-generation DES (PES/SES) reduce the need for reintervention as compared with BMS. Once the problem of stent thrombosis (ST) of the older-generation DES became known, many kinds of the newer-generation DES were developed. Everolimus-eluting stent (EES) is one of them. However, its efficacy and safety still remain uncertain compared with PES/SES in patients with acute myocardial infarction. Objectives: The purpose of this study was to compare the clinical outcomes of the EES with PES/SES at 2-year follow-up. Method: A total of 3,575 patients with AMI (1192 patients in the EES group and 2383 patients in the PES/SES group) were enrolled in a nationwide prospective Korea Acute Myocardial Infarction Registry (KAMIR) from January 2008 to June 2009 and underwent PCI with stent as standard therapy. The primary endpoints were major adverse cardiac events (MACE ; a composite of all cause of death, MI, and target lesion revascularization) and stent thrombosis during a 2-year clinical follow-up. Result: Two-year follow-up was completed in 1,339 patients. The groups had similar baseline characteristics. The primary end points occurred in 14.9% of EES patients and in 19.9% of PES/SES patients (Odds ratio [OR]: 0.71; 95% CI: 0.51 to 0.98) driven by a lower rate of all cause death and TLR. No significant differences were not found in the incidence of the definite and probable stent thrombosis (1.0% in EES group and 2.3% in PES/SES group, respectively). Conclusion: The newer-generation DES (EES) provided superior clinical outcome in terms of MACE and ST compared to the older-generation DES (PES/SES) at 2-year long-term follow-up in AMI patients.