Total arterial revascularization using off–pump coronary bypass and aortic no touch technique with BITA graft is safe and effective, with low complication rate and mortality among patient. Adding to its superiority to vein conduits, arteries allow high degree of versatility and long–term patency with minimizing need for reintervention especially in young patients and patients with atherosclerotic and porcelain aorta. Despite growing evidence of improved survival only minority of surgeons are using it, due to fear of deep sternal wound infection and learning curve associated with it.  Here we will discuss experience in our centre, techniques and associated complications associated with use of BITA graft for total arterial revascularization.