Cardiovascular disease is considered a major prob­lem in our society. Affected 110 million people and resulted in 8.9 million deaths. Use of pre-operative intra-aortic balloon pump (IABP) therapy is an effective modality in protecting high-risk patients undergoing coronary artery bypass grafting (CABG) surgery. The intra-aortic balloon pump (IABP) is a mechanical device that increases myocardial oxygen perfusion and simultaneously increases cardiac output. Increase cardiac output enhances coronary blood flow and therefore myocardial oxygen delivery. We observed that all were high risk cases and preoperative insertion of an intra-aortic balloon pump would benefit them. There were no cases of IABP-related mortality. No severe bleeding at the IABP insertion site, or balloon failure in any of the patients.