Background: The first widely acknowledged surgery for coronary artery disease is a coronary artery bypass graft (CABG), which uses a graft anastomosed between the aorta and the coronary artery distal to the lesion. In the 1960s, the first Off-pump CABG (OPCAB) surgeries were done and documented. When Cardio Pulmonary Bypass (CPB) is avoided, OPCAB might potentially give advantages such as decrease of systemic inflammation response, coagulopathy, renal dysfunction and cerebral impairment. OPCAB has become a well-established operation because of improvements in surgical methods and the development of improved cardiac stabilizing factors, particularly in high-risk patients. Off-pump approach in CABG surgery and its significance in organ preservation are the goals of this research. An OPCAB procedure may reduce in-hospital mortality and morbidity, especially for patients who are at higher risk for complications due to their medical condition.