Abstract: Objective To analyze the effect of carotid arteriostenosis and cerebral infarction on postoperative cerebral complications and survival rate after coronary artery bypass surgery grafting (CABG). Methods The effect of carotid arteriostenosis and cerebral infarction on postoperative cerebral complications and survival rate after CABG in 159 patients (67.0±7.5 years; 118 males and 41 females) admitted to our hosptial from June 2003 to June 2013 with carotid arteriostenosis and coronary heart diseases who accepted isolated CABG were retrospectively analyzed. Results Follow-up was done for 146 patients with a follow-up rate of 93.6% and the mean time of it was 6-120 (46.3±25.3) months. Ten patients had neurological symptoms, 2 patients got cerebral hemorrhage, 8 patients suffered from stroke. 17 patients had died during the follow-up (4 cerebral complication, 1 cancer of the esophagus, 1 lung cancer, 11 carcinogenic reason) with the mean time of 41(4-72) months after operation. The difference of postoperative cerebral complications and survival rate with different severity of carotid atherosclerosis had no statistical signifcance (P> 0.05). Patients with preoperative cerebral infarction had higher postoperative stroke and mortality, which marked statistical significance (P< 0.05). Conclusion Severity of carotid atherosclerosis can not increase the postoperative cerebral complications and survival rate, but patients with preoperative cerebral infarction are more likely to have stroke and higher mortality after operation than those patients with no cerebral infarction history.