Abstract Background: (CABG) is performed in patients with ischemic heart disease to improve long-term clinical outcomes, Several modifications have been made, including anastomosing technique, to improve long term patency. Aim of Study: To evaluate the efficacy and outcome of sequential grafting technique for multiple coronary arteries bypass. Patients and Methods: It is an interventional non rand-omized prospective study. Conducted from January 2019 till January 2020 at National Heart Institute, Cairo, Egypt. It included 50 patients who were prepared for on pump CABG for multi-vessel coronary artery disease. Results: Our study showed less operative time, least aortic manipulations, Troponin 6 hours post operatively 0.95±0.8 (ng/ml), no ECG ischemic changes were noticed. Conclusion: Sequential technique in coronary artery bypass grafting seems clinically accepted as safe and efficient procedure that can be used routinely in CABG.