Background Off-pump coronary artery bypass grafting (OPCAB) is used more widely in recent years in china.However there is argument for benefits and risks of off-pump surgery.Many studies shown that OPCAB has more benefits in short-term results compared with conventional coronary artery bypass grafting(CCABG).But there is some evidences shown that OPCAB has less long-term graft patency compared with on-pump surgery in other studies.Because of surgeons tendency in many studies off-pump or on-pump procedures had preformed by different surgeons.And practical level of surgeons may affect results of studies.Methods We selected 50 patients who had received surgical revascularization by same surgeon more than 5 years.There are 25 patients who received conventional coronary artery bypass grafting as group 1.In group 2, there are 25 patients who received OPCAB.All patients had angiograms to compare graft patency of two groups.Results There are 25 patients in group 1, 21 males and 4 females.Mean age of surgery is 55.4±8.9 years.Patients with unstable angina are 15 cases.There are16 patients with old myocardial infarction.Diabetes 6 cases.Ejection fraction (EF) is 58.39±14.35%.The mean number of bypasses per patient is 3.32±0.63.Mean operation time is 3.58±0.82 hrs.Mean follow up time is 86.52±12.48 months.There are 83 grafts which were evaluated for patency (open vs.closed) and assigned a FitzGibbon grade of A (excellent graft), B (impaired graft, with ≥50% stenosis and a reduction in the caliber of the graft to <50% of the grafted artery), or O (100% occluded graft).FitzGibbon A is 61 grafts, FitzGibbon B is 6 grafts, FitzGibbon O is 16 grafts, patency is 73.49%.In group 2, there are 25 patients, 21 males and 4 females too.Mean age of procedure is 58.2±9.09 years, the number of bypasses is 2.52±0.71 per patient.Patients with unstable angina are 11 cases.There are13 patients with old myocardial infarction.Diabetes 6 cases.Ejection fraction (EF) is 59.39±13.87%.The mean number of bypasses per patient is 2.52±0.71.Mean operation time is 2.71±0.63 hrs.There are 65 grafts total.Follow up 82.68±12.48 months, Grade A are 47 grafts, Grade B are 4 grafts, Grade O are 14 grafts, patency is 72.31%.Conclusions There is no different in long-term graft patency between on-pump and off-pump coronary artery bypass grafting.Off-pump coronary artery bypass grafting preformed by an experienced surgeon can gain good long-term graft patency as conventional bypass.