Abstract: AIM: To investigate the clinical effects of complete and incomplete revascularization in severe coronary heart disease (CHD) patients with three-vessel disease after drug-eluting stent (DES) implantation and to assess the significance of SYNTAX score in the treatment strategy for patients with three-vessel disease. METHODS: Included in this retrospective study were 118 consecutive CHD patients with three-vessel disease who had undergone successful DES implantation. Patients were divided into two groups: complete revascularization group and incomplete revascularization group. The occurrence of adverse events such as death, recurrence of angina, nonfatal myocardial infarction, nonfatal stroke and revascularization was followed up for 3 years after DES implantation and was analyzed with SYNTAX score. RESULTS: No significant difference was found in the incidence of MACCE adverse events including death, recurrence of angina, nonfatal myocardial infarction, nonfatal stroke and revascularization between groups but the total incidence of MACCE adverse events was significantly higher in the incomplete revascularization group compared with that in the complete revascularization group (19.4% vs. 8.9%, P<0.05). Compared with that in the complete revascularization group, a more increased tendency in the incidence of MACCE adverse events was found in the high and moderate scoring subgroups of SYNTAX score, more marked in the high score subgroup in the incomplete revascularization group. CONCLUSION: Effects of complete revascularization are much better than those of incomplete revascularization in CHD patients with three-vessel disease after DES implantation, especially in patients with high SYNTAX score.