Objective To evaluate the peri-operative anti-thrombotic strategy for the patients undergoing noncardiac surgery within 1 year after implantation of drug-eluting stent (DES). Methods A total of 48 patients who having taken dual antiplatelet therapy (DAPT) drugs (clopidogrel and aspirin) within l year after DES implantation and now undergoing operative treatment for the surgical diseases in our department from January 2010 to August 2013 were recruited in this study. They were randomly divided into heparin (enoxaparin) group and tirofiban group. In 5d before surgery, oral DAPT was stopped in both groups, and continuous intravenous infusion of 0.1μg/(kg·min) tirofiban or subcutaneous injection of enoxaparin (1mg/kg) twice per day, were performed respectively. In 12h before surgery, tirofiban or enoxaparin was stopped, and oral DAPT was returned as soon as possible after surgery according to the patients’ condition. Peri-operative cardiovascular events and bleeding were observed. Results There was no statistical significance in bridge time and surgery method between the 2 groups. No major adverse cardiac event (MACE) was observed in neither the enoxaparin nor the tirofiban group in perioperation. There were 2 cases of gingival bleeding and 1 of epistaxis in the enoxaparin group, and 1 of gingival bleeding and 1 positive occult test in the tirofiban group. But no difference was found in bleading incidence between the 2 groups. During the 3 months’ follow-up, 1 case of myocardial infarction and 2 of angina occurred in the enoxaparin group, and 1 of angina in the tirofiban group, with no difference in MACE in the 2 groups. Conclusion Low molecular weight heparin enoxaparin and Ⅱb/Ⅲa receptor antagonist tirofiban may be substitute for oral DAPT in the patients undergoing noncardiac surgery recently after implantation of DES.