Background: There are limited data on efficacy and safety of drug-eluting stent (DES) after chronic total occlusion (CTO) recanalization for left anterior descending artery (LAD). The aim of this study was to compare the mid- to long-term outcomes of DES use in patients with LAD versus non-LAD artery CTO lesions. Methods: A total of 2,084 patients with successful CTO recanalization with DES were enrolled from e-CTO multicenter registry. All patients were divided into 2 groups; LAD (n=901) and non-LAD (n=1183) groups. The CTO lesions with left main and saphenous vein graft were excluded. Major adverse cardiac events (MACE) including death, MI, TVR and stent thrombosis were evaluated at least after 6 months clinical follow-up after index procedure. Results: Baseline clinical characteristics were not different between the two groups;diabetes (32.8% vs 36.1% in non-LAD group, p=0.29), hypertension (60.8% vs. 62.4% in non-LAD group, p=0.75), history of smoking (52.6% vs. 53.3% in non-LAD group, p=0.43), hyperlipidemia (33.0% vs 33.6%, in non-LAD group, p=0.37). LAD group more frequently occurred in TVR (9.4% vs 6.3% in non-LAD group, p=0.012), MI (1.3% vs. 0.3% in non-LAD group, p=0.004) and MACE (14.4% vs. 10.3% in non-LAD group, p=0.005), but stent thrombosis was not showed significant difference in two groups (1.2% vs. 0.6% in non-LAD group, p=0.172) Conclusion: In this large cohort, successful CTO recanalization in the LAD lesion showed unfavorable clinical outcomes compared to non-LAD lesion, mainly driven by MI and TVR.