Abstract Surgical coronary revascularization is state-of-the-art therapy for cardiac ischemia. Even with scientific and procedural developments that narrow the gap between surgical and percutaneous revascularization strategies, surgical revascularization continues to demonstrate superior durability and greater long-term cost-effectiveness at the expense of greater invasiveness for the patient. Accordingly, cardiologists should understand the surgical perspective on coronary revascularization, particularly the surgeon's view of preoperative assessment and certain aspects of intraoperative decision making and postoperative care.