Introduction: Diabetic retinopathy (DMR) was reported to be a predictor of late clinical events after percutaneous coronary intervention (PCI). We had shown that the severity of DMR is associated with in-stent restenosis following PCI with bare metal stents. However, the correlation between DMR and major adverse cardiac events (MACE) or in-stent restenosis in diabetic patients who underwent drug-eluting stent implantation has not been evaluated yet. Methods: Of diabetic patients who underwent DES implantation from Feb. 2004 to Feb. 2005, we identified 61 subjects whose retinae were evaluated within 6 month prior to PCI. A grading of retinopathy was performed by trained and certificated ophthalmologists. MACE was defined as target vessel revascularization, myocardial infarction, or cardiac death. Six-month follow-up angiographic and clinical data were analyzed. Patients were divided into 3 groups according to the presence and the severity of DMR. Results: Clinical and angiographic follow-up data were available in all patients. There were no significant differences in baseline characteristics among 3 groups. Mean age was 61.7짹8.9. Mean BP was 129/79짹24/13. 50% of patients were men. Mean stent length/diameter were 30.7짹2.9 mm/2.89짹0.29 mm. The severity of DMR did not increase the risk of ISR. Of 23 patients without DMR, 2 patients (8.7%) developed ISR. In the cases of NPDR and PDR, 2 of 25 patients (8.0%) and 1 of 13 patients (7.7%) developed ISR respectively. But the presence of PDR was associated with the higher risk of MACE. For the patients without DMR, 2 patients (8.7%) developed MACE. But of the patients with NPDR and PDR, 4 (16.0%) patients and 6 (46.2%) patients developed MACE respectively. The odds ratio for MACE against no DMR were 2.00 (95% CI: 0.33~12.12) for NPDR and 9.00 (95% CI: 1.47~55.2) for PDR. Conclusions: Even in DES era, PDR seems to be a predictor for MACE. Patients with PDR may require aggressive medical treatment after PCI.