As the incidence of coronary heart disease (CHD) continues to increase, people’s understanding of CHD is gradually growing. From the initial fear of talking about it, it is now widely known. However, with the deepening of understanding and awareness, people have new confusion: is it better to have stent implantation or coronary artery bypass surgery for the treatment of coronary heart disease? Coronary artery disease is short for coronary atherosclerotic heart disease. Simply put, it is a narrowing or blockage of the blood vessels that supply blood to the heart. Since the heart needs to keep beating, the channels that supply it with nutrients are especially important. Once the coronary arteries become blocked, the blood supply to the heart muscle becomes insufficient. This can lead to angina pectoris in mild cases or life-threatening myocardial infarction in severe cases. Theoretically, thrombolysis and anticoagulation can restore blood supply to the heart when the coronary artery becomes narrowed or blocked at the very beginning. Therefore, in addition to drug treatment, modern medicine has started to use physical means to try to bring blood to the ischemic area of the heart muscle to reperfuse it. These physical means are known as surgery, and are now recognized as two distinct surgical methods: coronary artery bypass grafting (CABG) and coronary artery stenting (PCI). The principle of stenting is to insert a catheter into the coronary artery through the femoral or other artery under intervention (X-ray fluoroscopy), find and open the blocked vessel, and then prop up the vessel with an artificial stent to prevent restenosis. The patient is conscious throughout the procedure, which is done under local anesthesia only. Sometimes sedative medication is given to reduce fear and to allow the patient to pass through the procedure more smoothly. Stenting is a minimally invasive procedure, and patients can be out of bed 1-2 days after the procedure, and those who recover well can be discharged from the hospital within 1 week after the procedure. Unlike stenting, coronary artery bypass surgery solves the blockage problem by creating a second channel to bypass the blocked vessel. Currently, the autologous internal thoracic artery (located behind the sternum), radial artery (located in the forearm) and saphenous vein (located in the lower extremity) are often used as bridge vessels. The patency rate of autologous vessels is higher than that of stents, especially the long-term patency rate of arterial vessels is much higher than that of other materials. Coronary artery bypass surgery is currently divided into two types: “coronary artery bypass with cardiac arrest” and “coronary artery bypass without stopping”. All bypass surgeries are performed under general anesthesia, usually using a median sternal incision. The type and number of bypasses are determined by the extent of the coronary artery lesion, and currently 3-6 bypasses are commonly performed. The recovery period after bypass surgery takes about 7-10 days, and patients who recover well are usually discharged from the hospital within 10 days. “Coronary artery bypass grafting under cardiac arrest” and “coronary artery bypass grafting without stopping” have their own indications. For patients with coronary artery disease combined with heart valve disease and ventricular wall aneurysm, “stop-and-go coronary artery bypass grafting” must be used. For other patients, such as those of advanced age, it is generally considered that “non-stop bypass” can reduce the damage to the patient. Overall, non-stop bypass is relatively less invasive because it does not involve extracorporeal circulation. Compared with stenting, coronary artery bypass grafting has a long recovery period, more surgical side effects, and obvious incision scars, so many patients and their families are afraid of or even reject coronary artery bypass surgery. This kind of entanglement and rejection is often reflected in the treatment. In fact, this kind of obsession and rejection is not necessary. Clinical guidelines for the selection of treatment modalities are strictly adhered to. Coronary artery bypass grafting is often indicated for triple-vessel lesions (stenosis in all major coronary arteries), left main lesions (stenosis of the most important coronary artery) and left main-like lesions. If coronary artery disease is combined with other heart disease (heart valve disease or congenital heart disease) that cannot be addressed concurrently with interventional procedures, then cardiac arrest coronary artery bypass grafting is required. The latest European guidelines for the treatment of coronary artery disease even recommend coronary artery bypass grafting for patients with combined chronic diseases such as diabetes. However, for patients with acute myocardial infarction, due to the severity of myocardial damage, coronary artery bypass grafting is not recommended in principle, and the procedure should be performed after 1 month of coronary heart disease stabilization. Stent implantation is commonly used to open diseased coronary arteries in an emergency, and is generally applied to single or two-branch lesions, with simple, rapid and minimally invasive being its characteristics. Due to the stent itself, multiple stents are generally not used in succession to open the vessel. For patients with three-branch lesions, the long-term effect of stent implantation is inferior to that of coronary artery bypass grafting; while for patients with left main lesions, the risk of stent implantation is greater than that of coronary artery bypass grafting. Stenting for coronary artery disease should be attempted only in patients with three branches of lesions that cannot tolerate coronary artery bypass grafting for physical or other reasons. Therefore, the measure of merit is not based on surgical side effects alone, but rather varies from person to person and from condition to condition, combining factors such as long-term results and surgical risks. Choosing the appropriate treatment should not be a knot in the patient’s mind, but should be the job of all medical professionals according to treatment guidelines.