With the totality of data supporting coronary artery bypass graft (CABG) for mortality benefit, symptomatic angina, and quality of life improvement, CABG should be a class I indication for patients with ischemic cardiomyopathy and severe left ventricular dysfunction. As the population ages and more patients are referred for CABG, a careful risk-benefit assessment should be an important part of the consideration regarding revascularization strategies. A heart team approach is critical to arrive at the best decision for each patient. Age, alone, should not be a contraindication because there are data to support a reduction in cardiovascular mortality with CABG in older patients.