Patients with non-ST-elevation acute coronary syndromes should be classified according to the risk characteristics. This classification is helpful to determine both the prognosis and the treatment strategy in early period. In high risk patients, early invasive strategy includ- ing coronary angiography and percutaneous coronary angioplasty/stenting or coronary artery by-pass graft surgery (CABG) revascular- ization is recommended. As a surgical method, off-pump or classical method with cardiopulmonary by-pass CABG can be preferred. In both methods, the aim should be the protection of myocardium and complete revascularization. Clinical features, age, co-morbidities, vas- cular anatomy, surgical experience should be considered for choosing the revascularization technique.