Objective — to evaluate the effectiveness of ligation of the left atrial appendage (LAA) during off-pump coronary artery bypass surgery (OPCAB) for prevention of ischemic stroke (IS). Material and methods. A retrospective analysis of the results of OPCAB was carried out in 459 patients with CAD, who were operated in 2009—2013. Mean age of patients was 59±7.7 years (95% CI 58—59.5). There were 404 (88%) men. Previous hypertension was diagnosed in 212 (46.2%) cases, atrial fibrillation (AF) — in 125 (27.2%), diabetes mellitus — in 77 (16.8%), stroke — in 16 (3.5%) patients. Reduced ejection fraction (≤35%) was noted in 10 (2.2%) patients. Exclusion criteria: acute coronary syndrome, conversion to cardiopulmonary bypass, redo CABG, thrombosis of the left heart, significant lesions of supra-aortic vessels, concomitant cardiac diseases requiring intervention. Patients were divided into two groups: group I — 227 patients who underwent epicardial LAA ligation, group II (control) — 232 patients without LAA ligation. Median follow-up was 74 (59—79) months. Results. Incidence of in-hospital stroke was similar in both groups (0.4% vs. 26%, p=0.12). In delayed postoperative period, incidence of stroke was significantly higher in the 2nd group (4.2% vs. 15.2%; p=0.001). Conclusion. Routine ligation of LAA during OPCAB reduces the incidence of IS in long-term postoperative period.