Background: There are limited data whether the prognosis of diabetic non-ST segment elevation myocardial infarction (NSTEMI) patients (pts) with total occlusion in infarct-related artery (IRA) is worse compared with those of pts with non-total occlusion in IRA in the drug eluting stent (DES) era.Methods: The study population consisted of 416 consecutive acute NSTEMI pts with diabetes enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR) from November 2005 to June 2008.We compared the midterm clinical outcomes of diabetic NSTEMI pts with total occlusion in IRA (TIMI 0.1, n=164, 39.4%) to those of pts with non- total occlusion in IRA (TIMI 2,3, n=252, 60.6%) who underwent percutaneous coronary intervention (PCI) with DES. Results: The baseline clinical and angiographic characteristics were similar between the two groups except more beta blockers were used in pts with non total occlusion group. At 12-month, major clinical outcomes including Total deaths and Cardiac deaths, any MI, repeat PCI (Target lesion and vessel revascularization) and total major adverse cardiac events (MACE) were similar between the two groups by multivariate analysis (Table).Conclusion: The total occlusion in IRA group was a significant proportion (40%) in the high risk diabetic NSTEMI pts. However, they showed similar one-year cumulative clinical outcomes as compared with those of the non-total occlusion in IRA group in the DES era.