We report three patients who underwent a repair of abdominal aortic aneurysm (AAA) following a coronary artery bypass grafting (CABG) under the beating heart without cardiopulmonary bypass (off pump CABG; OPCAB) simultaneously. Patient 1, a 65-year-old man, had AAA and coronary artery disease (CAD), occlusion of right coronary artery (RCA). A right gastroepiploic artery (RGEA) to RCA anastomosis was followed by a prosthetic graft replacement for AAA. Patient 2 and 3 were a 66- and an 81-year-old men with AAA and left descending coronary artery (LAD) stenosis. The OPCAB to LAD with left internal thoracic artery (LITA) was performed after AAA repair. The postoperative courses were uneventful in all cases. They were discharged with patent grafts. Combined OPCAB and AAA repair on an one-step approach appears to be a useful therapeutic strategy for AAA patients with CAD.