Background Although the efficacy of drug-eluting stent (DES) is well known, there are few data about the clinical outcome of PCI using multiple overlapping DES in long lesion. We evaluated the clinical outcome between sirolimus-eluting stent (SES) and 2nd generation DES. Methods This study included 203 consecutive patients who underwent successful percutaneous coronary intervention (PCI) with multiple overlapping DES in long coronary artery lesion. The patients were divided into 2 groups: PCI with sirolimus eluting stent (SES, N=156) vs. PCI with 2nd generation DES (zotarolimus- and everolimus-eluting stent, N=47). We evaluated the incidence of major adverse cardiac events (MACE) including cardiac death, myocardial infarction, target lesion revascularization and stent thrombosis at 1 year. Results The incidence of MACE at 1 year was similar between 2 groups (7.7% in SES vs. 10.6% in 2nd generation DES, p=0.551). Also there was no significant difference in late loss (0.06짹0.67 mm in SES vs. 0.08짹0.70 in 2nd generation DES, p=0.891) Conclusions There was no significant difference in the incidence of 1-year MACE between SES and 2nd generation DES in long lesion. The use of multiple overlapping DES is effective with an acceptably safety.