Abstract: AIM:To compare the outcome of coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in diabetic patients with multivessel disease (MVD). METHODS: Two hundred and twenty-six diabetic patients with multivessel disease, clinically confirmed from June 2006 to March 2010, nonrandomly underwent CABG (n=105) or PCI (n=121). Clinical outcomes of the 1-year follow-up were compared. RESULTS: The number of older patients in the PCI group was higher than in the CABG group ［(63±6)years vs. (68±7)years, P<0.05］, but the number of hypertensive patients in the CABG group was higher than that in the PCI group (97.1% vs. 89.3%, P<0.05). No significant differences were observed in other baseline characteristics between groups. The 1-year follow-up showed a significant decrease of major adverse cardiac or cerebrovascular event (MACCE) in CABG group compared with that in the PCI group (14.3% vs. 28.1%, P<0.01). Additionally, the rate of target vessel revascularization (TVR) in the CABG group was much lower than in the PCI group (1.0% vs. 18.2%, P<0.01). No significant differences were observed in mortality, myocardial infarction and stroke between groups. CONCLUSION: Coronary artery bypass grafting is superior for diabetic patients with multivessel disease.