Drug-eluting stents have been a major advance in percutaneous coronary revascularization. Widespread use of these stents has been spurred by substantial reductions in restenosis rates when compared with bare metal stents. The use of drugeluting stents during ST-segment elevation myocardial infarction has been a common practice and is associated with lower revascularization rates in various studies. Unfortunately, significant concerns regarding the occurrence of late stent thrombosis with this technology persist. A clinical dilemma exists as to whether the benefits of reduced repeat revascularization with DES outweigh the harm caused by a possible increased occurrence of the infrequent but devastating complication of late stent thrombosis. This review with discuss the theoretical risks and benefits of DES for STEMI, the available data regarding their use, and the areas where future studies are needed.