Background: Differential angiographic outcomes in the currently available drug-eluting stents remain uncertain. Methods: Form the ZEST trial, which was a randomized multicenter trial comparing the outcomes of zotarolimus- (ZES), sirolimus- (SES) and paclitaxel-eluting stent (PES) for 3613 native coronary lesions, this angiographic substudy included lesions having serial coronary angiographies before and after procedure, and at 9 months. Lesions having angiographic surveillance before 4 months or after 12 months were excluded for analysis. The primary end point was angiographic restenosis rate with more than 50% of stenosis in analysis segment. All analyses were performed by intention-to-treat principle per lesion basis. Results: This angiographic cohort included 2032 lesions (56.2%) comprising 682 (33.6%) ZES, 684 (33.7%) SES, and 666 (32.8%) PES lesions. Angiographic outcomes are listed in the Table. Kaplan-Meier incidence of target lesion revascularization (TLR) at 13 months was 6.1% in ZES, 1.8% in SES, and 9.7% in PES (p<0.001 in 3 groups, SES vs. PES, and SES vs. ZES; p=0.018 between ZES vs. PES). However, in restenotic lesions, proliferative or total pattern were more common in ZES than PES (18.2% vs. 3.9%, p=0.008) Conclusion: In the systemic angiographic analysis of ZEST trial, SES was more effective in reducing restenosis and subsequent TLR than ZES or PES. In post-hoc analysis, although ZES had lower TLR rate than PES, angiographic restenosis rate did not differ between ZES and PES.