Abstract: AIM: To retrospectively investigate the timing and effectiveness of perioperative intraaortic balloon pump (IABP) in coronary artery bypass graft (CABG) patients. METHODS: Forty-five patients treated with IABP for severe coronary heart disease (CHD) from January 2003 to August 2009 were divided into three groups according to the time of IABP: preoperative group (n=13), intraoperative group (n=13) and postoperative group (n=19). Perioperative mortality, inotropic drug consumed time, postoperative cardiac index at 72 h, IABP support time, ventilation assist time and intensive care unit (ICU) stay time were analyzed and compared between the three groups. RESULTS: All 45 patients received CABG and total mortality was 31%. In the preoperative group, the postoperative cardiac index at 72 h was better than in both intra- and postoperative groups, whereas the IABP support time, ventilation assist time, length of stay in intensive care unit (ICU), time of intropic drug use and perioperative mortality were much lower than in intra- or postoperative group. CONCLUSION: IABP is a safe and effective mode for circulation support. For severe CHD patients, preoperative IABP is strongly recommended because it improves cardiac function, offers enhanced surgical safety and significantly decreases perioperative mortality.