Minimally invasive techniques have become a trend in recent years. Minimally invasive small incision coronary artery bypass grafting (MIDCAB) has been widely used in clinical practice because of its small incision, minimal trauma, aesthetics, rapid recovery, and high patient acceptance. At present, the common surgical paths of MIDCAB mainly include lower sternal, left anterolateral, right anterolateral and left parasternal small incisions. In our hospital, we have also carried out work in this area after 2009, mainly in the lower sternal segment and left anterolateral small incision. In the initial stage, there were fewer sources of disease, single lesions of the main descending branch and cases of failed PCI or restenosis after PCI. In the past two years, the application of small incisions was further broadened due to the affirmation of excellent medium and long-term results of left internal mammary artery-left anterior descending branch anastomosis, and with the promotion of hybridization technology, the patient volume has increased significantly compared to the previous ones. Compared with the traditional median sternal incision for CABG, the surgical incision is below the second and third intercostal space, which is about 8-12 cm long and lower, maintaining the lateral connection of the sternoclavicular joint, sternal stalk and sternal body, which is conducive to maintaining the integrity of the natural structure of the thorax, avoiding the fracture of the first rib and brachial plexus injury, facilitating the stability of the thorax, and reducing the impact on respiratory function due to surgical trauma. The small trauma of the sternum reduces the impact on the blood supply to the sternum, reduces the risk of sternal dissection, and reduces pain. At the same time, the skin incision is low and the incision is small, which is beneficial to the aesthetics. Compared with the classic small anterolateral incision, the lower median sternal incision does not require special instruments and the surgical field is relatively open, which makes the operation more convenient and skilled. Access to the internal mammary artery is quicker and easier and adequate. If required intraoperatively, the incision can easily be enlarged upward to a conventional median opening, reducing the risk of MIDCAB. The small incision on the left anterolateral side of the chest, the surgical incision is between the 4th/5th ribs at the left edge of the sternum, about 8-12 cm long, without cutting the sternum or disconnecting the ribs, further maintaining the integrity of the natural structure of the thorax. It avoids the risk of sternal dissection and the incision is concealed. However, the small left anterolateral incision requires a special sternal retractor, which makes intraoperative strain difficult. It is contraindicated in patients with a history of previous left-sided open-chest disease or severe lung disease. The indications for MIDCAB surgery are more controversial. It goes without saying that complete recanalization of multi-branch coronary lesions with small incisions increases the difficulty of surgical operation in general, and its minimally invasive significance is limited to small incisions, but for single or simple double-branch lesions, the reasonable choice of small-incision surgery does not increase the operational difficulty and surgical risk, and the clinical results are precise. The clinical data of MIDCAB in our hospital in the past five years showed that there was no surgical death, and the rate of complete disappearance of angina symptoms reached 97.6% at a follow-up of 2 months to 5 years. The clinical results are satisfactory. Therefore, the best clinical results can be achieved by reasonably selecting the materials and indications for small incisions, and the meaning of “minimally invasive” can be maximized.