Aim. To choice tactics of surgical treatment of advanced age patients with concomitant atherosclerotic lesion of coronary and brachiocephalic arteries. Material and methods. Since 2008 to 2012 in the department of CAD surgery of B.V. Petrovskiy Russian Research Center of Surgery 84 patients with hemodynamically significant lesion of coronary and cerebral arteries were operated. Mean age was 73.9±2.82 years. Various methods of CABG and CEA were applied. The patients were divided into 3 groups: group I (n=32) — simultaneous CABG and CEA; group II (n=38) — staged surgical treatment (CABG firstly followed by CEA); group III consisted of patients with hemodynamically significant diffuse changes of intracranial vessels (n=14) who underwent CABG alone. Results. Off-pump surgery and «no-touch aorta» technique are advisable to improve the results of treatment in advanced age patients with concomitant atherosclerotic lesion of coronary and brachiocephalic arteries.