OBJECTIVE: The aim of this study was to investigate the effect of control imaging after intravenous (IV) tirofiban infusion on the clinical outcome of patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: Patients who underwent PCI between June 2020 and October 2023 at our tertiary referral hospital and received tirofiban infusion were analyzed. Primary composite endpoint was the combination of cardiovascular death, myocardial infarction, cerebrovascular accident, or unplanned revascularization during follow-up. RESULTS: A total of 217 patients (22.6% female, mean age: 58 ± 13 years) with ACS who received IV tirofiban therapy after PCI were compared in three groups: Patients without additional procedure (n = 131), patients undergoing control coronary angiography after index PCI (n = 43), and patients undergoing additional PCI after index PCI (n = 43). The most common reason for clinical intervention was STEMI (65.9%). After approximately 1 year of follow-up, primary composite endpoint of cardiac death, myocardial infarction, cerebrovascular accident, or unplanned revascularization was similar in all groups (30 [22.9%] vs. 15 [35%] vs. 12 [28%], p = 0.290). CONCLUSION: Repeat coronary angiography and additional PCI after tirofiban infusion in patients undergoing index PCI were associated with similar cardiovascular outcomes at 1-year follow-up compared with no repeat coronary angiography.