ObjectiveTo explore the safety and efficacy of patients with dialysis-dependent end-stage renal disease who underwent coronary artery bypass grafting (CABG). Methods We retrospectively analyzed the data of 40 dialysis-dependent patients who underwent CABG in Beijing Anzhen Hospital between January 1, 2006 and August 20, 2013. There were 27 male and 13 female patients at mean age of 63.52±9.17 years. Of them, 33 patients underwent off-pump CABG were in the off-pump CABG group, while 7 patients underwent on-pump CABG were in the on-pump CABG group. ResultsThe average number of the grafts is 2.27±0.68. In the off-pump CABG group, 1 patient died from perioperative myocardial infarction with mortality of 3.0%.In the on-pump CABG group, the operative mortality was 28.6%, with 1 death because of serious infection and secondary multi-organ failure 15 days after the operation, and another death because of ventricular fibrillation 4 days after the operation. The follow-up rate was 100.00%. Overall mean follow-up time was 4.3±2.1 years. During the follow-up, the overall survival rate at 1 year, 3 years, and 5 years was 92.68%, 89.43%, and 82.04% respectively. ConclusionCABG can be performed in the patients with dialysis-dependent end-stage renal disease who also suffered with severe coronary artery disease, despite higher mortality. Surgeons should carefully select patients for the operation. Through optimal way of revascularization, and reasonable perioperative therapy, especially more actively use of continues renal replacement therapy, good results could be got in those kinds of patients.