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The present study retrospectively assessed clinical outcomes of proximal optimization technique (POT)-kissing-POT (PKP) and POT-side-POT (PSP) in ST-segment elevation myocardial infarction (STEMI) patients with culprit coronary bifurcation lesion (CBL) following a provisional stenting (PS). This large-scale multicenter (n = 10) study included STEMI patients with culprit CBLs who underwent PKP or PSP following PS. The primary endpoint was defined as the major adverse cardiac events (MACE; cardiac death, target vessel myocardial infarction [TVMI], or clinically driven target lesion revascularization [TLR]). Consecutive patients (n = 596; male: 491 [82.3%], mean age: 58.1 ± 11.7 years) were included. The study cohort was divided into 2 groups: PKP (n = 386) and PSP (n = 210). In the overall population, mid-term MACE (hazard ratio [HR]: 0.921, P = .461) did not differ in individuals with CBL-related STEMI treated with either PKP or PSP. The frequency of main vessel-TLR (0% vs 30%, P = .001) and main vessel-TVMI (0% vs 20%, P = .014) were significantly lower in the PKP group in the left main bifurcation localization. Diabetes mellitus (HR: 2.628, P < .001), high SYNTAX score (HR: 1.081, P < .001), and bifurcation localization (HR: 2.109, P = .014) were found to be independent predictors of MACE. In the overall population, risk-adjusted MACE rates for culprit CBLs were comparable between both techniques.