Background: Improvements in off-pump coronary artery bypass grafting (OPCABG) have focused interest on neurological injuries, such as stroke and cognitive decline, which may accompany an otherwise successful operation. The purpose of this study was to determine whether postoperative central nervous system (CNS) complications was related to prior cerebral infarction demonstrated by magnetic resonance imaging (MRI) or intracranial artery disease demonstrated by magnetic resonance angiography (MRA). Methods: The study sample comprised 55 consecutive patients (40 men; mean age, 64.59 +/- 8.86 years) who underwent OPCABG. Each patient underwent neurological and neuropsychological examinations 24 hours before surgery. MRI was used to identify old and/or new ischemic lesions before surgery and MRA was used to determine the presence and severity of intracranial artery disease. Patients were followed 8 days after surgery and evaluated for the development of stroke or cognitive dysfunction. Associations between postoperative stroke and potential predictors, including prior cerebral infarction and intracranial artery disease, were analyzed using univariate methods. Results: Two of 55 (3.64%) patients had postoperative stroke and no patient showed cognitive decline. Univariate analysis found no association between postoperative stroke and prior cerebral infarction detected by MRI (P=0.378) or intracranial artery disease detected by MRA (P=0.103). Conclusion: Our results suggest that intracranial artery disease and prior cerebral infarction detected on MRI are not independent risk factors for stroke after OPCABG. However, given the small sample of patients included in this study, further investigation of these associations is necessary.