Although outcomes have improved with new-generation drug-eluting stents (DES), few reports have analyzed the risk factors associated with chronic outcomes of chronic total occlusion (CTO)-percutaneous coronary intervention (PCI). This study aimed to investigate the independent risk factors for target lesion revascularization (TLR) and major adverse cardiac and cerebrovascular events (MACCEs) after CTO-PCI using Japanese multicenter data. A total of 3,666 patients, who underwent CTO-PCI and completed a 1-year follow-up, registered at the Japanese CTO-PCI Expert Registry, from 2014 to 2019 were examined. The primary outcome was defined as TLR, and the secondary outcome was MACCEs at the 1-year follow-up. TLRs and MACCEs occurred in 175 (4.8%) and 524 (14.3%) patients, respectively. Multivariate logistic regression analysis demonstrated that in-stent occlusion (ISO) (odds ratio [OR] 2.604; 95% confidence interval [CI], 1.695-4.001), hemodialysis (OR 1.784; 95% CI, 1.062-2.997), diabetes mellitus with insulin use (OR 1.741; 95% CI, 1.060-2.861), moderate-to-severe calcification (OR 1.726; 95% CI, 1.197-2.487), and the right coronary artery as the target vessel (OR 1.468; 95% CI, 1.018-2.117) were significantly associated with TLR. Hemodialysis (OR 2.214; 95% CI, 1.574-3.113), ISO (OR 1.499; 95% CI, 1.127-1.993), arteriosclerosis obliterans (OR 1.414; 95% CI, 1.074-1.863), and multivessel disease (OR 1.356; 95% CI, 1.117-1.647) were significantly associated with MACCEs. One-year outcomes of new generation DES for CTO-PCI were favorable, and ISO as a lesion factor and hemodialysis as a patient factor were strongly associated with TLR and MACCEs, respectively.