In this rapidly evolving era of coronary surgery, technologic advances have allowed the development of new myocardial revascularization strategies. Although conventional coronary artery bypass grafting is being challenged by other promising surgical procedures such as off-pump coronary artery bypass grafting, it remains the gold standard in patients with multivessel disease. Accurate evaluations of these new procedures are ongoing to assess their effectiveness and to define their role in the armamentarium of myocardial revascularization.