Background: We compared the long term clinical outcome in patients with multi-vessel coronary artery disease who underwent drug-eluting stent implantation either with conservative strategy or aggressive strategy to determine the impact of stenting strategies on the clinical outcome. Method: The study population was selected consecutively in a single center registry data. The definition of conservative strategy was intention to treat the only culprit lesions causing ischemia as short as possible. Aggressive strategy was defined as intention to treat all the visible angiographic lesions larger than 2.5mm in vessel size with stents long enough to cover the lesions completely. The primary end-point was major adverse cardiac events (cardiac death, non-fatal myocardial infarction [MI], target vessel revascularization [TVR]) at 24 months. Results: A total of 437 patients were included in the study, of whom 164 met criteria of conservative strategy and 273 met that of aggressive strategy. Baseline clinical and angiographic characteristics were well matched between groups. The Conservative strategy group received less number of stent implantation (1.64짹0.65 vs. 2.98짹0.72, p=0.0142) and shorter length stents (20.1짹4.5 mm vs. 26.8짹6.1 mm, p=0.036). Stent overlapping was more frequent in the aggressive strategy group (15.9% vs. 73.4%, p=0.002). At 24 months there was no discernable difference in the composite endpoint of major adverse cardiac events (17.7% vs. 14.39%, p=0.344). Cardiac death (1.8% vs. 1.1%, p=0.676), non-fatal MI (3.0% vs. 2.2%, p=0.754) and TVR (14.0% vs. 12.5%, p=0.661) were similar between groups. However target lesion revascularization rate was significantly lower in the conservative group (5.5% vs. 11.4%, p=0.041). Conclusion: Stenting strategy did not affect clinical outcome. Conservative treatment strategy might be a favorable option for multi-vessel coronary artery disease.