Background: There are few studies comparing the efficacy of different drug-eluting stents and their two-year clinical outcomes in percutaneous coronary intervention (PCI) of chronic total occlusive (CTO) lesions. Methods: We compared clinical outcomes of 124 patients (pts) with CTO successfully treated with implantation of sirolimus-eluting stents (SES) (n=44) versus paclitaxel-eluting stents (PES) (n=80) from 2004 to 2008. Results: There were no significant differences between the 2 groups, including age, gender, diabetes mellitus, hypertension, smoking history, hyperlipidemia, previous history of myocardial infarction, cilostazole use, hemoglobin, creatinine, and chronic kidney disease, except a tendency to more coronary vessel disease count (one-/two-/three-vessel disease count) in the PES group (P=0.137) and longer CTO length in the PES group (P=0.026) (table). At 2-year, major clinical outcomes including TLR, TVR, TLR-MACE, TVR-MACE, and Total MACE were higher in PES group compared with SES group (Table). When adjusted by CTO length and coronary vessel disease count, 2-year clinical outcomes including TVR, TVR MACE, Total MACE were higher in PES group (Table). Conclusions: CTO lesions treated with SES showed better 2-year clinical outcomes than those treated with PES