Background: Myocardial revascularization on a beating heart in case of the atherosclerotic affection of the coronory arteries. Material and methods: Retrospective analysis of 372 operations (myocardial revascularization without extracorporeal circulation) performed in 2002 October 2013. Results: In our study most patients were extubated within 24 hours. Mechanical ventilation of the lungs for more than 24 hours was required 11 patients (2.9%). Arrhythmias were 63 (17%) patients (atrial fibrillation – 56, atrial flutter – 7), that required additional administration of antiarrhythmic preparations to restore sinus rhythm, but in 11 cases was performed cardioversion. In the early postoperative period died 3 (0.8%) patients: 1 – acute renal failure, 1 – polyorganic failure, 1 – ventricular fibrillation. Conclusion: Off-pump coronary artery bypass (OPCAB) challenges the conventional on-pump coronary artery bypass grafting (CABG) as the standard of surgical therapy for coronary disease. Conventional coronary bypass surgery is associated with substantial morbidity caused by cardiopulmonary bypass. Conventional CABG has been performed with reproducible success, but complications cause significant morbidity and mortality. Some complications may be secondary to cardiopulmonary bypass (CPB) and include neurological dysfunction and a systemic inflammatory response syndrome ending in vital organ damage. Although OPCAB on a beating heart is an attractive alternative to conventional CABG on CPB, it also has drawbacks.