Aims While several cases have been reported, the occurrence and long-term fate of coronary artery aneurysm (CAA) associated with drug-eluting stents (DES) remains poorly clarified. We assessed clinical, angiographic characteristics and the outcomes of CAAs developed after DES implantation. Methods and results We evaluated 3612 patients undergoing follow-up angiography after DES implantation. A total of 34 CAA lesions (0.76%/lesion) occurred in 29 pts (0.8%/patient). Mean duration of follow-up of these patients was 806 + 340 days. Occurrence rate of CAA was not different according to the types of DES (0.73% in SES vs. 0.59% in PES, P=0.36). Saccular type of CAA was more frequently developed especially in SES compared to PES (96% vs. 55.5%, P = 0.021). Lesion length was significantly longer in CAA group compared no CAA group (26.9 짹 9.03 vs. 23.1 짹 7.14, P = 0.004). Acute myocardial infarction with very late stent thrombosis occurred in 4 cases (100%) who had discontinued clopidogrel in patients with CAA after DES. Conclusion Major morphological pattern of CAA was saccular type which was different according to the types of DES. Despite CAA associated with DES was rarely developed in real world, discontinuation of clopidogrel raised its possibility of stent thrombosis in patients with CAA associated with DES.