The radial artery is an easily harvested, versatile, and high-quality conduit with proven safety and efficacy during coronary artery bypass grafting. When properly harvested and deployed, the long-term patency is excellent and similar to the left internal thoracic artery. Either open or endoscopic harvesting may be used and target vessel stenosis should be at least 70%. Radial artery grafting is superior to saphenous vein grafting and appears to be equivalent to using the right internal thoracic artery. Adoption of radial artery grafting may be the most direct path to routine multiple arterial bypass grafting in the majority of patients undergoing coronary artery bypass grafting.