Objective: Endoscopic vessel harvesting (EVH) has superior cosmetic results and fewer wound complications than conventional open vessel harvesting (OVH), and has been reported to have satisfactory early clinical outcomes. However, mid-term outcomes after EVH remain controversial. This retrospective study, we analyzed the early and mid-term outcomes of EVH compared with OVH in patients with coronary artery bypass grafting. Methods: Isolated coronary artery bypass grafting using a saphenous vein graft was performed in 320 patients at our hospital between September 2009 and December 2016. One hundred forty-nine patients underwent EVH and 171 patients underwent OVH. Operative mortality, morbidity, early patency, wound complications, and 5-year survival were compared in the two groups. Early patency rates were assessed using angiography or computed tomography in 266 patients (414 anastomoses). Results: The success rate of EVH was 100%. Operative mortality was 2.0% in the EVH group and 1.8% in the OVH group, respectively. The early patency of the vein graft was 89.4% in the EVH group and 90.2% in the OVH group, respectively. EVH was associated with a lower incidence of harvest site wound complications relative to OVH (0.6% vs. 11.1%). Five-year survival was 82.7±5.2% in the EVH group and 78.3±4.3% in the OVH group, respectively. Five-year survival free from major adverse cardiac and cerebrovascular events was 51.2±9.2% in the EVH group and 59.5±5.1% in the OVH group, respectively. Conclusions: EVH decreased wound complications and had marked cosmetic advantages. The early and mid-term clinical outcomes of EVH were equivalent to those of OVH.