Background. To overcome the problems of late vein graft atherosclerosis, occlusion, and need of coronary reoperations, total arterial revascularization was adopted. In this study we compared this technique with the standard coronary revascularization technique using a single mammary artery and vein grafts.Methods. A total of 120 patients who had isolated coronary artery bypass grafting from October 2000 to October 2001 were evaluated. They were divided into two equal groups; group I (Total arterial coronary revascularization) and group II (Mixed coronary revascularization). Preoperative patient characteristics, bypass data, low cardiac output, mechanical ventilation, ICU and hospital stay were evaluated. Patients were followed up at six months to one year postoperatively. Assessment of the CCS class, ECG, echocardiography, Thallium scintigraphy and coronary angiography were done for 57 patients. Results. There was no statistically significant difference between the two groups as regards the incidence of the operative mortality, low cardiac output, perioperative infarction, period of mechanical ventilation, ICU and hospital stay, reopening for bleeding, sternal wound infection and the improvement of postoperative ejection fraction. 3.3% of patients in group II had a major lower limb wound infection while in group I, 2.4 % of patients had a superficial forearm infection, 2.4 % had a major forearm haematoma and 22 % had a temporary parasthesia of the thumb. However, the incidence of recurrence of angina was significantly higher (p=0.03) in group II (10.1%) than in group I (1.6%). Thallium scintigraphy revealed silent ischemia in 10.7 % of patients in group I, while postoperative coronary angiography revealed early postoperative closure of four out of nine (44.4%) saphenous vein graft studied. Conclusion. Total arterial coronary revascularization can be performed safely and may potentially avoid the sequelae of vein graft atherosclerosis.