Background : Treating coronary in-stent restenosis (ISR) has become one of the major challenges for the interventional cardiologists. The aim of this study was to compare cutting balloon angioplasty (CBA) with drug-eluting stent (DES) on prevention of recurrent restenosis in focal type of instent restenosis (ISR). Methods: This study included 56 patients treated by CBA (Group I: 59.6짹9.6 years, M:F=46:10) and 20 patients by DES (Group II: 61.0짹8.5 years, M:F=15:5) between January 2002 and December 2004. All patients had focal type of ISR (Group I - type IB: IC:ID=23:9:26, Group II - type IB:IC:ID=10:3:7). The 6-month angiographic restenosis rate and major adverse cardiac events (MACE) including death, myocardial infarction, or target lesion revasculartization (TLR) were compared between the two groups. Results: Baseline clinical characteristics were not different between the two groups. Follow-up coronary angiography was performed in 40 of 56 (71.4%) patients of group I and 15 of 20 patients (75%) of group II. Late loss was significantly lower in group I than in group II (0.69짹0.35 mm vs. 0.14짹0.24 mm, p<0.05). MACE during 6-month clinical follow-up developed in 8 (14.3%) patients in group I and 1 (5.0%) in group II (p<0.05). Conclusion: DES is associated with better clinical outcomes than CBA in the treatment of focal type of ISR.