Objectives: In the current era of stent usage, percutaneous coronary intervention (PCI) is more frequently performed as the initial revascularization strategy in multivessel disease before patients are finally referred to coronary artery bypass grafting. We sought to determine whether previous PCI has a prognostic impact on outcome in patients undergoing off-pump coronary artery bypass (OPCAB) surgery. Methods:: Between January 2001 and May 2006, 897 consecutive patients among 1059 patients undergoing isolated first-time OPCAB as the primary revascularization procedure (group 1) were evaluated for 30-day mortality and morbidity and compared with 162 patients during the same time period with previous PCI before OPCAB procedure (group 2). Mean follow-up was 35.6짹23.1 months. Results: All-cause 30-day mortality was 0.7% in group 1 and 2.5% in group 2 (odds ratio, 3.76; 95% confidence interval, 1.04-13.47; p=0.05). In-hospital major adverse cardiac events were identified in 4.6% and 5.6% (p=0.59), respectively. Risk-adjusted multivariate logistic regression analysis of previous percutaneous coronary intervention significantly correlated with 30-day mortality (odds ratio, 4.08; 95% confidence interval, 1.07-15.61; p=0.04). In terms of late results, 6-year actuarial survivals were 86.4짹2.4% and 90.9짹3.2%, respectively (p=0.63). There were no significant differences in 6-year freedoms from major adverse cardiac events and recurrence of anginal symptom, but 6-year freedoms from late cardiac readmission were significantly different (78.4짹2.4% and 67.6짹5.6%; p<0.01). Conclusion: Previous percutaneous coronary intervention before off-pump coronary artery bypass grafting independently increased the risk for 30-day mortality and was significantly correlated with late cardiac readmission.