Background and Objectives: Compared to bare metal stent, drug-eluting stent has 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 long-term clinical outcome of sirolimus-eluting stent (SES) in the treatment of very long lesions in the real word practice. Subjects and Methods: We implanted multiple SES (>40 mm in total length) in 113 de novo lesions in 113 patients. The average length of the implanted stents as 58짹14mm (41-112 mm) and 2.2 stents were implanted in each lesion and the average stent diameter was 3.0짹0.3 mm. The composite major cardiac events (MACE) of death, myocardial infarction (MI) and revascularization were evaluated at 1 year and 3 years. Results: Procedural and angiographic success were achieved in all patients without death or coronary artery bypass surgery. A six months follow up angiography was performed on 76 patients (67 %) and angiographic binary restenosis was developed in 7 patients (9.2%). During the three years follow up, there were four cardiac death (3.5%) and two non-cardiac death (1.8%), five non Q-wave MI (4.4%), one ST-segment elevated MI(0.9%), and one bypass surgery (0.9%). The MACE-free survival was 94 % at 12 months and 82 % at 3 years. Conclusion: The use of multiple, overlapping SES is safe and effective with an acceptably low follow up MACE rate.