Objective: The clinical results of the radial artery when proximally anastomosed to the aorta or to the left internal thoracic artery (LITA) as a composite Y-graft were comparatively evaluated. Methods: From November 1999 to March 2001, 100 patients who underwent coronary artery bypass grafting using the RA, the LITA and, when required, the saphenous vein, were divided into two groups of 50 patients each in a prospective randomized study. Group I (GI) with radial artery proximally anastomosed to the aorta and Group II (GII) as a composite graft (Y-graft) with the LITA. Results: Early mortality was 1.0% (GI 2.0% and GII 0.0%) (P=1.00). A mean of 3.0 ± 0.12 (GI) versus 2.82 ± 0.12 (GII) (p=0.29) coronary vessels were grafted per patient. Patients in composite Y-graft group had shorter bypass times (p=0.0001). There were no significant differences in terms of perioperative outcomes. Conclusions: The RA provides similar clinical results as aorto-coronary grafts and as composite Y-grafts with the LITA, except in respect to the bypass time.