Abstract Backgrounds : There has been the paucity of data for the safety of very low LDL-cholesterol level below 50 mg/dL in patients with coronary artery disease who underwent percutaneous coronary intervention. Methods : We analyzed a total 9,292 consecutive patients who underwent PCI using drug eluting stent from January 2004 to December 2009. Among these, 2704 subjects who had initial and follow-up lipid panel and attained low LDL-cholesterol (LDL-C<100mg/dL) with statin therapy were enrolled. Median follow up period was 28.3 months (interquartile range 15.1, 41.5 months). Laboratory study was performed at the time of index drug-eluting stent implantation and at the outpatient visit between three and twelve months later. We categorized patients into three groups based on the follow-up LDL-cholesterol level :<50, 50 to 70, 71 to 100 mg/dL(n=399, 1028, 1277, respectively). We compared major adverse cardiac events including all-cause death, nonfatal myocardial infarction, stroke and revascularization of any cause according to the follow up LDL-cholesterol group. Results : Multivariable Cox regression analysis revealed that in the patients with well controlled follow up LDL-C level (LDL<100 mg/dL), multivessel disease, presence of angiographic AHA/B2C lesion were strongly associated with increase in a hazard ratio of a composite of death, myocardial infarction, strtoke and revascularization of any cause. But LDL-C was not associated with the occurrence of MACEs. (Table 1.) Conclusions : In patients who underwent PCI with DES and well controlled LDL level, cholesterol paradox is not observed. It may be safe in patients with very low LDL-C level below 50 mg/dL in spite of continuous use of statin in terms of MACEs. Keywords : lipoprotein, hyperlipidemia, coronary heart disease, PCI