Background : Vessel size is an important predictor of clinical and angiographic outcomes in patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to compare the effectiveness of paclitaxel-eluting stent (PES) with bare-metal stent (BMS) in large coronary artery lesion. Methods : A total of 823 patients (N=494 in PES, N=329 in BMS) performed PCI using stents with 3.0 mm or more in diameter were retrospectively enrolled from March 2003 to June 2008. The primary end point was the composite of cardiac death, myocardial infarction and target vessel revascularization during 2 years. Results : The incidence of cardiac death was significantly higher in BMS than PES (6.1% in BMS vs. 3.5% in PES, p<0.001). There was also significant difference in the rate of myocardial infarction (3.2% in BMS vs. 0.9% in PES, p=0.028) and target vessel revascularization (10.3% in BMS vs. 4.8% in PES, p=0.006). In the multivariate analysis, the use of BMS (p=0.002, odd ratio=0.387) and stent size (p=0.013, odd ratio 0.378) were independent predictors of 2-year clinical events. Conclusion : During 2-year follow-up, the clinical outcome of PCI using stents with 3.0 mm or more in diameter was more favorable in patients with PES implantation.