Background: Left main disease stenting is increasingly performed as a valuable alternative to coronary artery bypass surgery (CABG), but clinical data regarding comparison of stenting and surgery are limited. Therefore, we evaluated the clinical outcome after stenting or bypass surgery in a single-center restrospective cohort study. Methods: From 1997 to 2005, 298 consecutive patients were treated with elective left main revascularization, using bare metal stent (BMS) (N=71); drug-eluting stent (DES) (N=63), or CABG (N=164). At the present writing, six-month clinical follow-up was completed in 234 patients (78.5%) and survival analysis was performed for this population. Results: There was no difference of clinical parameters except higher frequency of diabetes (71%) in CABG group than BMS (23%) and DES (32%) group. Freedom from all major adverse events (MACE), including death, myocardial infarction, and cerebrovascular events, of DES at 6 month (96.6%) and 12 month (96.6%) was comparable to that of CABG (99.3%) (p=NS for log-rank test), and significantly higher than that of BMS (83.6%) (p<0.001 for log-rank test). Freedom from MACE of DES (94.7%) at 1 year was also comparable to that of CABG (95.9%) and significantly higher than that of BMS (73.8%) (p<0.001 for log-rank test). There was one periprocedural shock, who was recovered by percutaneous cardiopulmonary support, and two deaths including one procedural failure and one subacute thrombosis in DES group. Conclusion: Although this is non-randomized retrospective study, our results show that DES implantation for left main disease appears feasible and has favorable clinical midterm result in selected cases. Detailed data would be presented at the meeting.