There are certain surgical indications for undergoing bypass surgery, which has become the mainstay of treatment for coronary heart disease since 1967, when the world’s first case of coronary artery bypass grafting was utilized for the treatment of coronary heart disease. Its immediate and long-term effects have been confirmed by a large number of cases and long follow-ups worldwide. The main principle of bypass surgery is to maximize the improvement of myocardial ischemia and minimize the risk to the patient. The lesion is taken into account in the choice of treatment. The main conditions for which studies have confirmed that coronary artery bypass grafting should be performed include: (1) Left main stem lesion with a stenotic lesion greater than 50%. (2) Equivalent left main stem lesions, i.e., significant stenosis (≥70% or more) in the proximal segment of the left anterior descending branch and the proximal segment of the left circumflex branch, should be selected for bypass surgery. (3) Combined diabetes mellitus with two or more vascular lesions, especially two vascular lesions with stenosis in the proximal part of the anterior descending branch. (4) Diffuse lesions of three or more vessels with left heart hypoplasia should undergo bypass surgery. (5) Acute myocardial infarction with cardiogenic shock. (6) Combination of cardiac mechanical complications requiring surgical treatment such as tendon cable rupture mitral regurgitation, ventricular septal perforation or combined ventricular wall tumor. (7) Stable angina with ineffective medical treatment, unstable angina; post-infarction angina; myocardial infarction without Q wave. (8) Failure of partial intervention or acute complications, such as severe coronary artery injury. In conclusion: the basic indication for bypass surgery is myocardial ischemia symptoms of medical treatment failed to control the patient, in general, the patient’s symptoms of severe ischemia, the larger the scope of stenosis, the more severe the bypass effect is better. If the coronary artery disease is diffuse, the distal coronary artery can not bypass surgery, severe cardio-cerebral, pulmonary, hepatic and renal insufficiency can not withstand the trauma of the operation for the contraindication.