Background and Objectives: Stent fracture (SF) is an important mechanism of in-stent restenosis (ISR) after implantation of drug-eluting stent (DES), especially sirolimus-eluting stent (SES). The aim of this study is to evaluate long-term clinical outcomes of patients with SF. Materials and methods: From Dec. 2003 to Dec. 2007, 98 patients with 99 lesions who had SF that was detected during coronary angiography for routine follow-up or adverse events after DES implantation were enrolled. SF without ISR was found in 43 patients (Group 1) and with ISR in 55 patients (Group 2). Clinical and angiographic follow-up were done and major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and target vessel revascularization (TVR) were elucidated after detection of SF. Results: All SFs were developed in SES (100%) and total stent length was 44.7짹19.7mm. Dominant site and vessel was middle (53.5%, 53/99) right coronary artery (58.2%, 58/99). Clinical follow up was done in all patients (100%) for 568짹381 days and angiographic follow-up was performed in 43% (42/98) after detection of SF. At the moment of SF detection, in Group 2, clinical follow-up with dual antiplatelet therapy was done in 51.1%, simple or cutting balloon dilatation without stenting was performed in 34.9% and another stent was re-implanted in 14%. During follow-up, overall MACE was developed in 11.2% (11/98). While one TLR with MI were developed in Group 1, 10 TLR was developed in Group 2 (1.8% vs. 23.3%, p=0.001), but no death was found. Conclusion: Long-term follow-up of SF after SES implantation might have an increased risk of adverse cardiac events, especially in patients with ISR at the detection of SF. Large-scale prospective studies are needed for the exact clinical sequelae of SF. Key Words: Drug-eluting stent, Fracture, In-stent restenosis, Outcomes, MACE