This is written so as to report the case of a 75-year-old male with a diagnosis of sigmoid adenocarcinoma accompanied by critical coronary artery disease and angina, which was subject to simultaneous surgical treatment. Was performed first an on – pump coronary artery revascularization and then a left colectomy. Our case suggests that performing an on-pump bypass in patient also with reduced ejection fraction procedure prior to cancer surgery can be a safe surgical in appropriately selected cases.