Drug-eluting stents reduce restenosis after percutaneous coronary intervention, but may carry an increased risk of late stent thrombosis compared with bare metal stents. Delayed endothelialization may contribute to this phenomenon, that carries a considerable mortality. The current review discusses recent data regarding the risk of late stent thrombosis with drug-eluting stents. An important risk factor is premature discontinuation of antiplatelet therapy, and patients with drug-eluting stents should adhere to dual antiplatelet therapy for one year after stent implantation.