We have reported on changes in the nature and outcome of coronary artery bypass surgery over the past 30 years, focusing on surgery performed last year, from January 1 to December 31, 2000. The operative mortality for patients who underwent only coronary artery bypass surgery was 2.75% in 2000. Mortality for initial elective surgery was 1.73%. These are the best results obtained since surveys were started. The percentage of elderly patients undergoing coronary artery bypass surgery is rising annually. In 2000, 40.8% of patients were aged 70 years or older and 5.3% were aged 80 years or older. Mortality in elderly patients undergoing initial elective surgery is decreasing, with a mortality of 2.5% for patients aged 70 years or older and 2.9% for patients aged 80 years or older. Off-pump coronary artery bypass grafting was performed on 3,356 patients in 2000. Median sternotomy was used in the majority of cases, with 2,988 patients undergoing surgery by this approach. Use of minimally invasive direct coronary artery bypass (MIDCAB) peaked in 1998 but is becoming less common, with only 280 patients undergoing this procedure in 2000.