Background: Adjunctive Cilostazol (Pletaal짰) to dual antiplatelet therapy (triple antiplatelet) is associated with favorable clinical outcomes in selective group of patients (pts). However, the efficacy and safety of triple antiplatelet therapy in all comers undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES) in real-world is unclear yet. Methods: The study population consisted of 1,689 consecutive pts who underwent PCI with DES from April 2006 to February 2009 in daily clinical practice without any particular exclusion. Usage of adjunctive Cilostazol to dual antiplatelet regimen (asprin + clopidogrel) was depending on physician���s discretion. Cilostazol was administered by 200mg post-loading and then 100mg bid for at least one month. Clinical and angiographic outcomes at 6 months of triple group were compared with those of dual antiplatelet group.Results: Out of 1689 enrolled pts, 659 pts (39.02%) received Triple and 1030 pts (60.98%) Dual therapy. Pts with Cilostazol group had more male (69.8% vs. 64.1%, P=0.015), worse baseline angiographic characteristics including more bifurcation (34.6% vs. 28.9 %, P=0.001), left main (7.9% vs. 2.3%, P<0.001), diffuse long (34.1% vs. 26.8%, P=0.001) and Ostial Lesions (19.9% vs. 13.9%, P=0.001). Despite the higher risk subset of pts in Cilostazol group, major clinical hard endpoints, incidence of stent thrombosis and angiographic outcomes were similar between the two groups (Table). Conclusion: Triple antiplatelet therapy including adjunctive Cilostazol in high risk pts undergoing PCI with DES in real world clinical practice showed similar midterm clinical and angiographic outcomes compared with those of usual pts with dual antiplatelet therapy.