This prospective randomized study was carried out from 2003 till 2004, in the department of cardiothoracic surgery Kasr El Ainy Faculty of Medicine including 60 CABG surgery patients: 55 men/ 5 women forming matching 30-patients groups as group (A): patients of Total Arterial Coronary Revascularization (TACR) with LIMA/RA grafts & group (B):conventional LIMA/SVGS grafts. Postoperative follow-up was done for for 1 year. Mean operative time was longer in TACR (245 ± 13.5 minutes), versus conventional (198 ± 8.2 minutes) with similar mean aortic cross-clamp time. More number of anastomotic points was done (3.1 ± 0.1 points) in conventional; vs. TACR (2.9 ± 0.1 points). Intraoperatively, inotropics support was used to wean off-CPB in more TACR patients at a higher mean dose. One patient died (3.3 %) in each group. TACR patients needed longer mean mechanical ventilation, ICU & hospital stay times using more inotropic support & one patient needed IABCP support. New MI developed in 3 TACR patients vs. 1 conventional patient. Deep sternal wound infection occurred equally in 1 patient in each group, with temporary “radial” thumb paraesthesia in 2 patients after TACR. Fllow-up showed clinical improvement in both groups without further complications. We found that compared to conventional CABG, TACR using (LIMA/RA) did not increase operative or early postoperative mortality, provided proper myocardial revascularization (with no signs of total obstruction), with higher associated morbidity.