Between October 1976 and December 1991, 36 patients with Kawasaki disease underwent coronary bypass surgery. Comparisons were made from the postoperative morphologic condition of 4 conduits; saphenous vein graft (SVG n = 27), left internal thoracic artery (LITA n = 22), right internal thoracic artery (RITA n = 5) and gastroepiploic artery (GEA n = 8). The patency rate of arterial grafts was 100% at 1 month after surgery, and kept as high as 94.7% at 1-3 years after surgery. On the other hand, the patency rate of SVG was 90% at 1 month, but decreased to 52% at 1-3 years postoperatively. Arterial grafts sometimes showed string sign at 1 month after surgery, but the length and the diameter increased during 1 year after surgery. The internal thoracic artery showed superior flow potential compared with GEA. Thus, the internal thoracic artery is the first choice and GEA is the second as the graft material with Kawasaki disease. Long-term result of SVG was very poor, so coronary revascularization only by the arterial grafts is recommended.