Backgrounds: The high efficacy of the drug-eluting stent (DES) to prevent restenosis has changed much of the practice pattern. We tried to determine the impact of DES on surgical practice and also tried to compare the efficacy of DES with CABG in the treatment of the patients with multivessel coronary artery disease (MVCAD). Methods and Results: In the first step, we analyzed the data of the 409 patients who underwent CABG between March 2002 and Feb 2005 to determine the impact of DES on surgical practice. We divided this enroll period into three - before DES (~Feb 2003), early DES, (~Feb 2004) and DES under insurance (March 2004~). After the DES introduction, patient population of CABG become more complicated and the rate of hybrid CABG was significantly increased. In the second step, we analyzed the data of 378 patients who underwent DES implantation (181 patients) or off-pump coronary artery bypass (OPCAB) (197 patients) for triple vessel disease or left main disease from March 2002 to February 2004. Patients who underwent combined surgery and those who underwent revascularization in an emergency setting were excluded. DES group was older (65.5짹10.2 vs. 62.3짹10.3, p<0.05), had more female patients (36.5% vs. 25.4%, p<0.05) and had less left main disease patients (11.6% vs. 38.6%,p<0.05). Survival rate was similar in each group at 1 year follow-up (96.1% in DES group and 98.5% in CABG group, p=0.01). Target vessel revascularization (TVR) rate was 9.9% in DES group, which was much lower than that of bare metal stent, but significantly higher than that of CABG group (3.1%, p=0.01). Due to the high TVR rate, 1 year MACE (TVR, MI or Death) rate was higher in DES group (13.8% vs. 5.1%, p<0.01). In the multivariate analysis, DES group showed higher rate of 1 year MACE (OR 3.08, 1.31-7.25). But, in subgroup analysis, revascularization with multi-vessel DES stenting was not associated with increased 1year MACE in the group of non-diabetic patients (OR 2.00, 0.72 ~ 5.58) and in the group of good LV systolic function (OR 1.25, 0.34 ~ 4.64). Conclusions: DES and CABG could be a good cooperator, as in the hybrid CABG, and also could be a good competitor for better revascularization technique.