Background Several studies identified independent clinical predictors of restenosis including female gender, diabetes, hypertension, smoking, body mass index, multivessel disease, and multiple stenting. The aim of this study is to assess the relationship of epicardial adipose tissue (EAT) and clinical outcomes after percutaneous coronary intervention (PCI). Methods We consecutively enrolled 399 patients (273 males, 59짹11 year-old) with angiographically significant coronary artery disease, who received successful PCI. One year angiographic follow-up was obtained and angiographic outcomes were compared with EAT thickness by echocardiography. Clinical restenosis was defined as target lesion revascularization (TLR) at 1 year. TLR was defined as clinically indicated percutaneous or surgical revascularization of the index lesion during follow-up. Revascularization was decided clinically indicated if there was >70% diameter stenosis on angiography or >50% stenosis together with a positive stress test or ischemic symptoms. The target lesion was considered to be the area covered by the previous stent site plus a 5-mm margin proximal and distal to the stent edges. Results Median and mean EAT of 399 patients were (median 3.1 mm) and 3.3짹1.9 mm, respectively. The mean follow-up interval was 12짹5 months. Mean EAT was significantly increased in patients undergoing TLR than those without clinical restenosis (3.2짹1.9 vs. 3.8짹1.8 mm, p=0.003). Table shows the multiple logistic analysis of the clinical predictors for restenosis. In addition to the well-known restenosis predictors, such as multivessel disease, multiple stenting, and smoking, EAT was an independent factor associated with clinical restenosis in this study population. Conclusion This study demonstrates that the EAT thickness is related with clinical restenosis in patients who underwent successful PCI. The EAT thickness might provide additional information for future restenosis after coronary stenting.