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Malignant ventricular arrhythmias (sustained ventricular tachycardia [VT] and ventricular fibrillation [VF]) are uncommon, but serious complications after coronary artery bypass grafting. Patient factors and surgery-related factors place post-operative CABG patients at higher risk for malignant ventricular arrhythmias. Although establishing the diagnosis in the immediate postoperative period is fairly straightforward in the era of continuous telemetry monitoring, establishing a cause of VT/VF is more challenging. Treatment options are varied, from pharmacologic to surgical to long-term prophylaxis. Patients may be candidates for electrophysiologic ablation or ICD therapy. As the cardiac surgical population becomes older with more comorbidities, skilled postoperative management of VT and VF will be essential to favorable outcomes.