Aim. To compare long-term outcomes of coronary artery bypass surgery using microsurgical and standard technique for distal anastomoses. Material and methods. It was analyzed 10-year results of 193 patients who underwent elective coronary artery bypass grafting (CABG) in 1999-2001. Analysis included survival, angina recurrence, incidence of non-fatal myocardial infarction and reoperation rate. Initially patients were randomized into two groups: microsurgical technique (n=89) and conventional technique (n=104). Survival analysis was performed using Kaplan-Meier method. Results. 10-year survival in case of microsurgical method compared with conventional technique was 84,3 and 70,2% (p=0,03); non-fatal myocardial infarction incidence - 9,6 and 21,2% (p=0,03); angina recurrence - 14,4 and 25,5% (p=ns); reoperation rate - 10,8 and 22,3% (p=0,04), respectively. Conclusion. The use of surgical microscope and microsurgical technique decreases mortality, non-fatal myocardial infarction incidence and reoperation rate. Thus, the use of large optical magnification has a positive effect on survival and efficacy of coronary surgery during follow-up.