The interventional armamentarium for the treatment of patients with multivessel coronary artery disease (CAD) typically bifurcates into two options either by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Coronary revascularization procedures are increasingly being performed in patients who are at high risk of mortality or morbidity. In multivessel coronary disease with complex LAD lesions, hybrid coronary revascularization (HCR) is used. It is a minimally invasive alternative robotic or thoracoscopic off-pump strategy which amalgamates the excellent long-term patency and survival benefit of LIMA-LAD grafting with the minimal invasiveness of PCI to treat non-LAD lesions, thereby achieving complete revascularization. In this chapter the evolution, indication, contraindications, technical aspects, guidelines of HCR are discussed in detail.