Background: Compared to bare metal stents, drug-eluting stents have improved clinical and angiographic outcomes in de novo, simple lesions. In the real world practice, we often meet more complex, long lesions which increase restenosis and cardiovascular events. The aim of this study was to evaluate the clinical and angiographic outcome of sirolimus-eluting stents (SES) in the treatment of very long lesions. Methods and Results: We implanted multiple SES stents (>40 mm in total length) in 113 de novo lesions in 113 patients. The average length of the implanted stents as 57짹14mm (41-112 mm) and 2.2 stents (2-4 stents) were implanted in each lesion and the average stent diameter was 3.0짹0.3 mm. Procedural and angiographic success were achieved in all patients without death or coronary artery bypass surgery. Non-Q wave MI (CK-MB���2 times normal value) was developed in 13 patients (11.5%). One patient had a late stent thrombosis 50 days after the procedure (0.9%). There were two sudden cardiac deaths and one non-cardiac death. The major adverse cardiac event(MACE)-free survival was 93% at 12 months. Angiographic in-stent restenosis was developed in 7 patients (9.2%). All of them were focal type in-stent restenosis. Conclusion: In conclusion, long lesion coverage with SES stent is feasible with a favorable mid-term outcome in the real world practice.