Background: The relative efficacy and safety of Everolimus-eluting stents versus paclitaxel-eluting stents in the small coronary vessels (<2.75mm) remains less well defined so the objective was to assess the twelve months outcome of the Everolimus –eluting stents (EES) versus the Paclitaxel-Eluting Stent (PES ) in the small coronary vessels ( <2.75mm) coronary intervention. Methods:.91patients referred for coronary intervention with reference vessel diameter (R.V..D.) <2.75mm were randomly assigned to either EES or PES. The primary endpoint was target vessel revascularization (TVR) at twelve months follow up. Out of the 91 patients enrolled, 53.8% were assigned to receive EES; 46.2% were assigned to receive PES. Results: a significantly lower TVR among the EES group (2% versus 14.2%),p=0.03. Likewise, instent restenosis (ISR) rate was significantly lower among the EES group ( 6.1% versus 21.4%), p=0.031.On the other hand ; there were no significant differences in the rates of deaths ; target vessel- related myocardial infarction or stent thrombosis between the two groups. Conclusion: Both stents were similarly safe while EES is more effective.