Background and Objectives: End-stage renal disease (ESRD) has been suggested as a strong determinant for major adverse cardiac events (MACE) or stent thrombosis (ST) after drug-eluting stent (DES) implantation. The aim of this study is to assess the major determinants for MACE and ST in patients with ESRD on dialysis following stent implantation and evaluate the safety of DES during the long-term follow-up. Subjects and Methods: Between March 2003 and July 2005, a total of 105 patients with ESRD undergoing sirolimus-eluting stents (SES; n=54) or bare-metal stents (BMS; n=51) implantation were enrolled in a Korean Multicenter Angioplasty Team (KOMATE) Registry. To determine the independent predictors for the occurrence of MACE [death, acute myocardial infarction, and target-vessel revascularization] or ST, by Academic Research Consortium definition, we performed multivariate regression. Results; Mean follow-up duration was 917 짹 209 days. The independent predictors for the occurrence of MACE in patients with ESRD on dialysis during follow-up were age [odds ratio (OR)=1.08, 95% confidence interval (CI)=1.02-1.13, p=0.005], use of BMS (OR=2.91, 95% CI=1.16-7.91, p=0.022) and presence of hypertension (OR=11.34, 95% CI=1.23-101.87, p=0.032). The independent predictor for mortality was age (OR=1.09, 95% CI=1.02-1.16, p=0.010). The most determinant for the occurrence of definite or probable ST was the total numbers of implanted stents (OR=2.29, 95% CI=1.24-4.24, p=0.008). Conclusions: The major determinants for MACE and ST in patients with ESRD on dialysis following stent implantation were age, use of BMS, hypertension, and total numbers of implanted stents. SES, compared with BMS, was not a predictor for MACE or ST in patients with ESRD during the long-term follow-up.