Purpose: It is unknown whether the one-stent bifurcation stenting approach with stenting of the main vessel (MV) should be finalized by a kissing balloon dilatation (FKBD). Therefore, we compared strategies of MV stenting with and without FKBD. Methods and Results We retrospectively analyzed 393 patients (FKBD, n=322 and no- FKBD, n=71) with a bifurcation lesion, which was treated with MV stenting with drug-eluting stent. During follow-up (median 46 months), MACE (cardiac death, non-fatal myocardial infarction, and target lesion revascularization) occurred more in no-FKBD group [6.5% (n=21) for FKBD vs. 16.9% (n=12) for no-FKBD, P=0.02]. The incidence of periprocedural MI was not different statistically between the both groups (13.2% vs. 6.8%, p=0.25). In cox regression analysis, FKBD was a independent predictor of MACE (HR = 0.42;95% CI 0.19 to 0.94; p=0.04). Conclusions: Our study showed that FKBD was associated with better long-term clinical outcome in patients with coronary bifurcation treated MV stenting. Key words: • bifurcation • final kissing ballooning • Drug-eluting stents