Background: Several pharmacological interventions have been shown to modulate ISR process in vitro and despite were efficient in reducing restenosis in animal models; however, in clinical trials still most of these attempts did not successfully limit neointimal formation after coronary stenting. Objectives: This study aimed to evaluate the effect of pioglitazone treatment on ISR rates among diabetic patients subjected to coronary intervention using bare metal stent (BMS) treated with versus without pioglitazone. Methods: 97 diabetic patients were grouped according to pioglitazone treatment or not to G1 and G2.% diameter stenosis (%DS) and ISR rates were assessed after 13 months of coronary intervention (Using BMS). Results: ISR rates were 21.3% versus 42% in patients treated with versus without pioglitazone (p = 0.028), no significant difference in the metabolic variables (HbA1c, fasting insulin and lipid profile) between the 2 groups were found, negative correlation between the use of pioglitazone and ISR, positive correlation between stent length, hs-CRP and ISR, the use of pioglitazone decreases the risk of ISR by two times (OR = 1.54, CI = 1.07-2.22 and p = 0.02), after adjusting for the different predictors using multivariate regression models; pioglitazone was powerful predictor of low ISR risk (OR = 1.26, CI = 1.03-1.53 and p = 0.001). Conclusion: 13 month pioglitazone treatment following coronary intervention (using BMS) in diabetics decreased ISR risk irrespective of its metabolic action.