Surgical revascularization in patients with poor left ventricular function has historically carried a high mortality and morbidity rates. However, with advances in surgical techniques and myocardial protection, the safety of CABG in those patients has been demonstrated. The aim of this study is to investigate the early surgical outcome in patients with poor left ventricular function (EF < 35%) in comparison with patients having normal left ventricular function (EF > 50%). This study included 155 patients with ischaemic heart disease, that were retrospectively grouped into, group I including 71 patients with a left ventricular function < 0.35 and group II including 84 patients with normal left ventricular function ( > 0.50). All patients were subjected to conventional CABG with the use of cardiopulmonary bypass. There are more males in group I (63, 88.7%, P < 0.012), and patients in this group tend to be more obese, had more incidences of hypertension (43, 60.6%, P < 0.036), hypercholestermia (26, 36.6, P < 0.006) and Diabetes (40, 56.30%, P < 0.006). Also they tend to have more incidences of MI (46, 64.8%, P < 0.001), CHF (34, 66.7%, P < 0.001) and higher mean NYHA ( 2.3 ± 0.5 , P < 0.001). Otherwise, there was no statistically significant difference between both groups. The overall in-hospital mortality was 3.9% ( n = 6). Four patients died in group I (5.6%) and 2 in group II (2.4%). There was a significantly longer mean bypass time and cross-clamp time in group I (81.4 ± 12 versus 66.6 ± 12.1 min; P < 0.001 and 43.7 ± 7.3 versus 36.5 ± 5.9 min; P < 0.001, respectively). Also, Patients in group I had more prolonged ICU stay (58.3 ± 11.2 versus 41.8 ± 11.6 h; P < 0.001), more patients needed IABP (24 patients, 33.8% versus 6 patients, 7.1%, P < 0.001); and more patients needed positive inotropic support (55 patients, 77.5% versus 39 patients, 46.4%, P < 0.001) compared to Group II patients. There was highly significant improvement in postoperative NYHA class in both groups( P < 0.001), however there were more improvement in group I (33.1, 95% confidence interval 26.22 to 39.98 versus 30.1, 95% CI 24.07 to 36.24). EF has significantly improved in group I postoperatively ( P < 0.001), however, there were no statistical difference in group II. Other postoperative outcomes were insignificantly different between compared groups. CABG in patients with poor function can be performed with low mortality and morbidity. Low ejection fraction does not preclude CABG provided careful patient selection is implemented.