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Background Cardiopulmonary bypass (CPB) produces a well-documented diffuse inflammatory response that affects multiple organ systems. To avoid the deleterious effects of cardiopulmonary bypass, off-pump coronary artery bypass grafting is becoming increasingly popular world- wide.We reviewed our experience of complete coronary artery revascularization on the beating heart without CPB.Methods From Aug 1998 to Aug 2000, 860off-pump revascularizations (99 % since January 1999) were performed at Manipal Hospital Heart Foundation. The patients consist of males 757(88%), females 103(12%) . Averaged age 64. 2±15years. All surgeries were performed through a median steotomy. Exposure techniques are tailored to individual vessels and cardiac regions. Local immobilization is performed with octopus. Vascular control is achieved with occluders and shunts. Results Among 860 off-pump CABG patients. Single graft 72(8.3 % ), two grafts 208 (24. 2 % ), three grafts 469(54.5 % ), four grafts 101 (11.8 % ), five graft 10(1.2 % ) . The average number of grafts per patient was 2.72 ±0. 32. Operative mortality was 0.69 % (6patients). Anesthetic time 3.9 + 1.2hours, extubation time 6 ± 2. 5 hours, Blood requirement 360 ±90 ml,Preoperative LVEF 60.2 + 8.5 %, Post LVEF 64. 1 +14 % Low cardiac output 48 patients (5.6 % ), IABP requirement: 25 patients(2.9 %), 25 patients converted to CPB during OP-CAB (2.9 % ) and 20 of them were done with on pump beating heart. 25 patientsshowed myocardial ischemic and 16 patients showed perioperative myocardial infarction. ICU stay 1. 1 ± 0.8days, hospital stay 6.2±1.1 days. Conclusion Off-pump coronary artery bypass in complete revas cularization is a safe, effective technique and suitable.