In this article, the author reflects on 60 years of coronary artery bypass grafting (CABG), outlining its origins, the role of early surgical-cardiology collaboration, and its place alongside advances in medical therapy. Despite improvements in guideline-directed treatment, patients with extensive coronary disease still rely on CABG. The central message is that CABG remains the most durable revascularization strategy and will continue to be needed until true disease modifying therapies emerge.