Over the past 30 years, we have reported on status and outcome of coronary artery bypass surgery in Japan. This report is focused on surgery performed last year, from January 1 to December 31, 2002. A total of 13,474 cases underwent coronary artery bypass grafting (CABG) of these, 12,552 underwent CABG only. The operative mortality for patients who underwent CABG only was 2.04% in 2002. Mortality for initial elective CABG was 1.02%. These are the best results obtained since surveys were started. The percentage of elderly patients undergoing coronary artery bypass surgery is rising annually. In 2002, 44.4% of patients were aged 70 years or older and 6.9% were aged 80 years or older. Mortality in elderly patients undergoing initial elective surgery is decreasing, with a mortality of 1.3% for patients aged 70 years or older and 2.0% for patients aged 80 years or older. Since 1996, the number of off-pump CABG (OPCAB) cases remarkably increased annually. This less-invasive procedure was performed on 5,628 patients in 2002, which is 41.8% of the total number of CABG cases.