Abstract: AIM To evaluate the ability of different scoring methods for long-term prognosis of patients with multivessel disease after PCI. METHODS 192 consecutive patients with ACS undergoing PCI at the department of Cardiology of the Inner Mongolia Autonomous Region people’s Hospital were studied from January 2013 to May 2014. Among the clinical data collected included gender, age, clinical diagnosis, doppler echocardiography, peripheral vascular ultrasound, blood lipids, and renal function. SYNTAX Score, SYNTAX Score II, clinical SYNTAX Score, EuroScore2, and ESRS with 2 years clinical follow-up at the same time were measured. Follow-up measurements included main adverse cardiovascular and cerebrovascular events (MACCE) including all-cause death, stroke, coronary reascularization, heart failure, and hospitalization for angina pectoris. RESULTS There were 24 cases of MACCE in 192 patients with ACS, including cardiac death in 7 cases, stroke death in 2 cases, revascularization in 7 cases, ischemic stroke in 6 cases, heart failure in 4 cases. The SYNTAX score, SYNTAX score II, clinical SYNTAX score and EuroScore2 score were 18±6 vs.15±7 (P<0.05), 29±5 vs. 27±8 (P<0.05), 41±16 vs. 36±22 (P<0.05), 4.0±3.6 vs. 2.7±2.1 (P<0.05) in event group and non event groups, respectively. The rate of MACCE with ESRS in the high-risk, and low-risk groups were 29%, 21%, P<0.05, respectively. The area under the curve for predicting the 2 years endpoint events of SYNTAX score, SYNTAX score II, clinical SYNTAX score, EuroScore2 score and ESRS, respectively were 0.631, 0.631, 0.630, 0.634, 0.656 (all P<0.05). High-risk patients in risk stratification were relative to MACCE regardless of which kind of scoring methods were evaluated. CONCLUSION The SYNTAX score, SYNTAX score II, clinical SYNTAX score, EuroScore2 and ESRS utilized to predict MACCE had no significant difference.