We report a 77-year-old man treated successfully surgical coronary revascularization following out-of-hospital cardiac arrest. The patient suddenly suffered from loss of consciousness with cardiopulmonary arrest on June 3, 2007. His wife quickly started cardiac massage and a bystander called an ambulance. Using an automated external defibrillator, paramedics performed defibrillation, which started his heart beating again in 30 min. He was then transferred by ambulance to the emergency room in our hospital. Severe coronary artery disease (left main disease and three-vessel disease) was diagnosed on June 11 after treatment for congestive heart failure and confirmation of good consciousness. Thereafter, urgent on-pump beating coronary artery bypass grafting was performed. On the 45th post operative day, the patient was discharged to home with an acceptable level of daily life activity. To the best of our knowledge, this is the fifth such case report in the Japanese literature.