Background: Aorto-ostial lesions (AOL) are associated with suboptimal angiographic results because of lesion rigidity and recoil. This study evaluated the angiographic and clinical outcomes of patients with AOL treated with drug-eluting stents implantation. Method: We retrospectively identified 90 consecutive patients who underwent percutaneous coronary intervention in 90 AOL involving the left main (31 lesions), right coronary artery (59 lesions). Sixty three AOLs were implanted with 82 Sirolimus-eluting stents (SES), 24 AOL with 30 Paclitaxel-eluting stents (PES) and 3 AOLs with 3 Zotarolimus-eluting stents (ZES). Results: Angiogrphic success rate was 100%. In hospital, two patients were died of non-Q myocardial infarction (MI), and one of two cases was related with subacute stent thrombosis. At 1 year follow-up, total 6 patients (7 %) died. Among them, 2 patients (2 %) died of MI, 4 patients (4 %) died of non-cardiac causes. Total 4 patients (4 %) (3 patients in the SES group, 1 patient in the PES group) underwent target lesion revascularization. Cumulative 1-year major adverse cardiac event (MACE) occurred in 10 patients (11 %); 5 patients in the SES group, 4 patient in the PES group, 1 patient in the ZES group. Angiographic follow-up rate was 53 % and in stent restenosis rate was 15%. Quantitative coronary angiography showed late lumen loss was 0.62 짹 0.76 mm (0.58 짹 0.75 mm for SES group, 0.76 짹 0.84 mm for PES group, 0.58 mm for ZES group). There was no difference in the rate of MACE in left main ostial lesions versus right coronary ostial lesions (3.3 vs. 7.8%, p=0.751).. Conclusions: Drug eluting stent implantation in aorto-ostial lesions showed relatively low clinical and angiographic event rate. The clinical event rate of left main coronary artery ostial lesions was not differen from that of right coronary artery ostial lesions. Drug eluting stent implantation is safe and effective method in the treatment of aorto-ostial lesions.