Background and objectives Drug-eluting stents (DESs) are superior to bare metal stents (BMSs) in decreasing restenosis rates across a wide range of patient and lesion subsets. However, widespread utilization of DESs raises risks of prolonged dual antiplatelet therapy, the potential for late adverse events such as late thrombosis, and cost. Vessel diameter and lesion length have been previously identified as predictors for restenosis for DESs and BMSs. This study compared the clinical outcomes of DESs versus BMSs in patients with large coronary arteries(���3.5 mm). Methods This study was perfomed retrospectively. 135 patients who underwent single-vessel angioplasty with DESs implantation in large vessels, and 115 patients who received BMSs were included in this study. The clinical outcomes at 12 months were compared between groups. Study end points were major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, and need for target vessel and target lesion revascularization. Results Lesion length was longer (18.1 짹 8.1 mm for DESs group vs 11.7 짹 4.0 mm for BMSs group; P < 0.0001) and stent diameter was larger (60% vs 78% for 3.5 mm and 37% vs 20% for 4.0 mm stent in DESs and BMSs group, respectively; P = 0.01) significantly in the group treated with DESs. Other baseline clinical and procedural characteristics were similar. 90.3% of patients with DESs and 88.7% of patients received BMSs were free of MACE (P = 0.68). The rate of target lesion revascularization was higher in the BMSs group (5.9% vs 9.5%; P = 0.29), but that was statistically insignificant. Conclusion Implantation fo DESs in large coronary arteries confers no additional benefit compared with BMSs, and the 2 approaches are associated with equally favorable clinical outcomes at 12 months.