Background Current treatment options of percutaneous coronary intervention (PCI) for diffuse long lesion include implantation of a single long stent or multiple contiguous stents. A 38-mm TAXUS Liberte짰 Paclitaxel-Eluting Stent (PES) is one of the longest available drug-eluting stent (DES) and can reduce the number of stents, costs, and simplifying procedures. However, the long term clinical outcomes of single long stenting versus multiple overlapping stenting were not clearly established yet. Methods Among the 2061 patients (pts) who underwent PCI in Korea University Guro Hospital from April, 2003 to September, 2009, a total of 595 pts who were exclusively treated with PES were enrolled for the study. The pts were divided into 2 groups: single 38 mm PES (n=30 pts) and multiple overlapping PES (n=183 pts) groups. Angiographic outcomes at 6 months and cumulative major clinical outcomes up to 24 months were evaluated between the two groups. Results Baseline clinical and procedural characteristics were similar between two groups except single 38 mm PES group had higher incidence of diabetes mellitus (48.4% vs 25.7%, p=0.017) and diffuse lesion (68.5% vs 56.8%, p=0.075), whereas multiple overlapping PES group had lower ejection fraction (EF, 52.08 짹 11.12 vs 45.79 짹 12.94, p=0.033). Angiographic outcomes at 6 months and major clinical outcomes including death, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR) and major adverse cardiac events (MACE) up to 24 months were similar between the two groups (Table). Conclusion In our study, pts with diffuse long lesion treated with single 38 mm PES had similar angiographic outcomes at 6 months and clinical outcomes up to 24 months compared with those of multiple overlapping PES, suggestive of cost-effectiveness of single 38mm stenting.