Objective — to analyze the results of myocardial revascularization in postmenopausal women with coronary artery disease. Material and methods. There were 250 postmenopausal women aged 45—79 years with coronary artery disease who underwent myocardial revascularization for the period 2006—2019. Mean age of patients was 65.2±5.7 years. Hormone therapy was administered in 11 (4.4%) patients. In most cases, angiographic and intraoperative data confirmed small diameter of the coronary arteries. Operating microscope was used in 45 (18%) patients, cardiopulmonary bypass — in 118 (47.2%) patients. Results. Revascularization index was 3.5±0.7. Expected revascularization index in case of CABG under standard 3.5—4.5-fold magnification in patients who underwent microsurgical revascularization (n=45) would be 2.8±0.4. In-hospital mortality was 3.2% (n=8). Perioperative myocardial infarction developed in 5 (2%) of patients, paroxysmal atrial fibrillation — in 35 (14%). Acute cerebrovascular accident occurred in 1 (0.4%) patient. Conclusion. Surgical treatment of CAD in postmenopausal patients with multiple risk factors requires personalized surgical approach in order to obtain favorable outcomes. The use of operating microscope increases revascularization index and may be optimal in patients with thin coronary arteries and diffuse distal coronary lesion. Cardiopulmonary bypass does not increase the risk of in-hospital complications.