Objective: Small coronary artery stenting has been known for high rates of restenosis and clinical events even in the era of drug-eluting stents. There has been no study comparing angiographic and clinical outcomes among patients with sirolimus- (SES, n=558), paclitaxel- (PES, n=117), zotarolimus- (ZES, n=223), and everolimus-eluting stent (EES, n=651) implantation in small coronary artery stenosis. Methods: Propensity matching was performed among 4 groups, and coronary lesions with reference diameter of < 2.75mm were included in the study. Late lumen loss and rates of in-stent restenosis at 9 month follow-up were compared among 4 groups, and major adverse cardiovascular events (MACEs) such as all-cause death, non-fatal myocardial infarction, stroke, and target lesion revascularization (TLR) were compared among 4 groups during the 3 year follow-up. Results: Late lumen loss was significantly lower in the EES group when compared with the PES and ZES groups (0.31 짹 0.11 mm, 0.57 짹 0.12 mm 0.66 짹 0.14 mm, respectively, P<0.05). However, no significant difference was found between the EES and SES groups (0.31 짹 0.11 mm and 0.45 짹 0.19 mm, respectively, P=0.52). Rates of in-stent restenosis were significantly lower in the EES groups when compared with the PES and ZES groups (4.8%, 8.1%, 8.9%, respectively). Rate of TLR was significantly lower in the in the EES group when compared with the SES, PES and ZES groups (1.8%, 9.9%, 12.0%, 8.1%, respectively). Rates of MACE during the 3 year follow-up were significantly lower in the EES group when compared with the SES, PES, and ZES groups (4.5%, 13.4%, 15.4%, 10.3%, respectively) (Figure 1). Conclusions: Rate of MACEs was significantly lower in the EES group when compared with the SES, PES, and ZES groups, mainly due to the lower rate of TLR during the 3-year follow-up.