Background: Sirolims-eluting stent(SES) has been shown to markedly reduce the restenosis, compared with bare metal stent(BMS). However, a lot of clinical trials have excluded subset of patients(pts) with end stage renal disease(ESRD). The aim of this study is to evaluate clinical outcomes following SES implantation. Methods: We analyzed clinical outcomes following SES implantation in 50 pts with ESRD in our registry, and compared outcomes between pts with ESRD received SES(SES-ESRD) and those with ESRD received BMS(BMS-ESRD), and compared SES-ESRD group with non-ESRD patients following SES implantation(SES-non ESRD) in our registry too. Results: 1) A comparison of SES-SRD group(50 pts, 72 lesions) with BMS-ESRD group(42 pts, 45 lesions). SES-ESRD group was; male 66%, diabetes 78%, hypertension 94%, and age 62짹10.3 years. SES-ESRD was more likely to have diabetes(diabetes of BME-ESRD, 57%; p=0.04). Reference vessel diameters(RVD) of SES-ESRD were smaller, and lesion length was longer than those of BMS-ESRD. SES-ESRD had a lower mortality rate at 1 year (4% vs 0.6%, p<0.01). The incidence of one-year major adverse cardiac events(MACE) was lower than SES-ESRD (p<0.01). 2) A comparison with SES-non ESRD groupin our total registry(661 pts, 758 lesions). MACE of SES-ESRD group was higher than SES-non ESRD. After adjusting clinical and angiographic characteristics, ESRD remained the most important predictor of MACE(relative risk=2.2, p=0.03). Conclusion: Compared with BMS, SES has caused improved clinical outcomes in pts with ESRD. However, ESRD still remained major risk factor of cardiac event following coronary intervention due to multiple combined risk factors.