Background Although many studies showed clinical impact of female (FM) gender to worse prognosis in coronary artery disease, it has not been clearly established in the patients with acute myocardial infarction (AMI) after drug-eluting stents (DES) implantation. Methods Between May 2005 to Jan 2010, we analyzed retrospectively the 1370 AMI patients (mean 60.6짹12.8 years old, 332 (24.2%) FMs) with DES implantation from Infarction Prognosis Study registry. Cardiac death and major adverse cardiovascular events (MACEs) including cardiac death, non-fatal MI, target lesion and vessel revascularization were evaluated using Cox model adjusted with covariates which showed difference between both gender groups or significance to prognosis by univariate analysis. Results The patients were followed up mean 214짹194 days. Cardiac death (9% vs 6%, p=0.019) and MACEs (16% vs 8%, p<0.001) showed more in the FM patients. After adjustment, FM gender had hazard ratio (HR) 1.25 (p=0.617) for cardiac death and HR 1.87 (p=0.014) for MACEs. And FM gender was a more significant predictor in the patients with non-ST elevation MI (NSTEMI), 3 vessel disease (3VD) or left main disease (LM), or higher left ventricular ejection fraction (LVEF). A HR of FM gender for MACEs was 2.59 (p=0.010) in NSTEMI, 2.71 (p=0.012) in 3VD or LM, and 2.46 (p=0.013) in the patients with LVEF >=45%. Conclusion FM patients may had more risk of MACEs after DES implantation, especially in the patients with preserved LVEF or NSTEMI or high risk angiographic findings.