Objective: We compared the outcomes of coronary artery bypass surgery using bilateral internal thoracic artery (BITA) and right gastroepiploic artery (RGEA) in addition to BITA with off-pump and aortic no-touch technique in triple-vessel disease. Method: From March 2001 to April 2006, 512 consecutive patients with triple-vessel disease underwent total arterial revascularization with off-pump and aortic no-touch technique, using BITA or RGEA in addition to BITA. Left-side revascularization was performed with composite Y graft using BITA in all cases. In 353 patients RCA grafting was performed with the distal extesion of right internal thoracic artery (BITA group) and in 159 patients with in situ RGEA (BITA plus RGEA group). Results: In BITA plus RGEA group, more distal anastomosis were performed (4.39 짹 0.9 versus 4.04 짹 0.7; p < 0.001). One 30-day mortality occurred in BITA group and none in BITA plus RGEA group. Deep sternal wound infection occurred in 2 patients in BITA group and none in BITA plus RGEA group. Early outcomes in both groups were similar. Actuarial freedom from cardiac death in BITA group and in BITA plus RGEA group were 98.5% and 97.6% at 5 years after the operation, respectively (p=0.996). Actuarial freedom from cardiac events including return of angina in BITA group and in BITA plus RGEA group were 87.2% and 95.0% at 5 years after the operation, respectively(p=0.044). Conclusion: Off-pump coronary bypass with aortic no-touch technique using BITA or BITA plus RGEA graft can be performed with good results and low mortality in triple-vessel disease. Patients undergoing BITA plus RGEA grafting appeared to have lower cardiac events than patients undergoing BITA grafting.