Aim To explore and analyze the advantage of off-pump coronary artery bypass (OPCAB) compared with conventional coronary artery bypass (CCAB). Methods 92 cases of CCAB and 151 cases of OPCAB were collected from Nov.1998 to Dec.2008, and the clinical data were summarized and analyzed retrospectively. Results The preoperation risk factors had no significant difference between CCAB group and OPCAB group except for diabetes. There were more mean graft numbers in CCAB group than in OPCAB group. But operation time, intubation time, ICU stay time, postoperative stay time, low cardiac output, IABP use time and renal dysfunction in OPCAB group were obviously less than in CCAB group, with no significant difference in hospital death between the two groups. Seven years postoperative follow-up result indicated that heart function improved obviously and ejection fraction (EF) value was higher in OPCAB group than in CCAB group. Conclusions There was apparent advantage in postoperation recovery and reduction of postoperation complications in OPCAB compared with CCAB, and OPCAB is a hopeful surgical method for coronary artery disease. The heart function recovers more quickly in OPCAB group than in CCAB group. The rate of graft occlusion in OPCAB group was higher than in CCAB group.