Dual antiplatelet therapy (DAPT), typically consisting of aspirin and a P2Y12 inhibitor, is a cornerstone therapy following percutaneous coronary intervention (PCI). However, the optimal duration of DAPT remains debated due to a trade-off between ischemic protection and bleeding risk. This study evaluates clinical outcomes associated with short-term (≤6 months), standard-term (12 months), and extended (>12 months) DAPT durations in PCI patients, focusing on mortality, stent thrombosis, recurrent myocardial infarction (MI), and major bleeding events. A retrospective cohort analysis of 2,500 post-PCI patients was conducted across five tertiary care hospitals over a five-year period. Results showed extended therapy reduced late stent thrombosis but significantly increased bleeding risk, whereas short-term therapy showed favorable outcomes in low-risk and elderly populations. Findings support a personalized risk-based approach rather than a standardized duration model.