Background: Many studies about sex differences after AMI demonstrated that women have higher mortality than men and usually receive less aggressive treatment and higher risk of adverse outcomes after percutaneous coronary intervention (PCI) than do men. However, long-term outcomes of women after contemporary PCI in AMI with DES have not been fully investigated. We investigated the impact of sex on outcomes and success after primary PCI with drug-eluting stent (DES) in AMI. Methods: Between 2006 and 2008, 1819 eligible patients (1386 male, 433 female; age=60.8 짹 12.5 years) were analyzed. The treatment strategy of AMI and their prognosis were analyzed according to the sex differences in the field of STEMI and NTEMI by using KAMIR data. Results: Female AMI patients were significantly older than males (STEMI: 58짹12 vs 69짹9 years; NSTEMI: 56짹11 vs 68짹9 years, p <0.001, respectively) and have more frequently have comorbidities such as hypertension and diabetes in STEMI field. In the initial selection of treatment strategy, there was no sex difference between males and females in KAMIR. Successful rate of PCI in STEMI was not different between the both sexes (96.4% vs 95.6%, p=0.398), but in NSTEMI, failed PCI rate was higher in females than males (1.6% vs 5.8%, p=0.005). The procedural complexity was not different in both sexes, nevertheless, major adverse cardiac event (MACE) developed more frequently in women than men with both STEMI (1 month: 3.1 vs 7.4%, p<0.001; 12 months: 13.4 vs 17.3%, p=0.031) and NSTEMI (1 month: 4.8 vs 11.7%, p<0.001; 12 months: 17.7 vs 23.5%, p<0.005), especially in cardiac death. Conclusions: Although DES era, long-term cardiac mortality and failed rate of PCI have higher in women than men in patients with AMI.