Objective To evaluate the quality of life status in patients aged 70 years and over following off-pump coronary artery bypass (OPCAB) grafting. Methods Seventy-eight patients with coronary heart disease [mean age (74.6 ± 5.3) years, 66 males, 12 females] were investigated retrospectively. Three questionnaires about the quality of life, including Seattle Angina Questionnaire (SAQ), Nottingham Healthy Profile (Part Ⅰ NHP) and Duke Activity Status Index (DASD, were used to investigate patients before and after OPCAB. Results Prior to OPCAB, there was lower quality of life index in males than in females [SAQ: (65.3±5.1) vs. (69.5±8.1); NHP: (89.4±17.3) vs. (125.2±19.9), P＜0.01; DASI: (4. 1±1.1) vs. (4.3± 1.3)]. At the 12th months after OPCABG, there were significant improvements in all patients. The effects were less pronounced in females than in males [SAQ: (83.1 ±5.8) vs. (88.5±4.5), P＜0.05; NHP: (84.7± 11.7) vs.(91.4±13.7), P＜0.05; DASI: (4.7±1.4) vs. (5.4±1.1)]. Conclusions Our study shows that OPCAB improves quality of life in elderly patients with coronary heart disease. The benefits of OPCAB are even more pronounced in male patients.