Although rare in the stent era, coronary artery perforation (CAP) may cause myocardial infarction, repeat percutaneous coronary intervention (PCI), or even death in 5–10% of cases (depending on the severity of the perforation) [1]. Here, we present a case of type-V CAP complicating primary PCI for anterior ST-segment elevation myocardial infarction. A 48-year-old man with history of diabetes mellitus presented with acute progressive chest pain of 12-hour duration. ECG showed evidence of anterior ST-segment elevation myocardial infarction. He underwent primary PCI (door to device time: 60 minutes) with implantation of two overlapping drug-eluting stents (2.5 × 18 mm distally and 2.75 × 22 mm proximally) to the left anterior descending artery (LAD). The patient’s chest pain disappeared, and he was hemodynamically stable with blood pressure of 130/80 mmHg. Angiography showed satisfactory stent results, but minor contrast extravasation was observed in the distal LAD segment