Background; Small vessel is known to be an independent predictor of restenosis following PCI. DES has been demonstrated to improve the outcomes of these patients. However, whether there are differences between the efficacy of sirolimus- and paclitaxel-eluting stent is not clarified yet. Methods; A total 137 patients with 143 denovo small coronary lesions (<2.50 mm) were treated with either Cypher (61 pts, 67 lesions) or Taxus (71 pts, 76 lesions). Six-month angiographic and clinical outcomes were compared between two groups. Results; The baseline characteristics were well matched between the two groups. The percentage of procedure success was similarly high in both groups (100.0% vs. 97.2%, p=0.500). Six-month angiographic outcomes showed that the incidence of binary restenosis and late loss were lower in SES group compared PES group(13.9% vs 27.7%, P=0.041 and 0.52 ± 0.41 vs 0.84 ± 0.65, P=0.032). Despite these angiographic benefits, clinical outcomes were similar between two groups. At 6-month follow up, the survival and freedom from MACEs was similar between two groups (96.06% vs. 97.4%, p=0.419). Conclusion; In this small sample-sized study, DES implantation in patients with small lesions was safe, either SES or PES. SES for the treatment of small coronary lesions showed more angiographically favorable results compared with PES but failed to translate its benefits into better clinical outcomes.