Introduction. Despite an active study of the problem of ischemic mitral regurgitation, studies of its connections with the degree and localization of coronary artery lesions are contradictory.Objective. Study the features of coronary artery lesions according to coronary angiography in patients with ischemic heart disease and ischemic mitral regurgitation and the connections between the severity of coronary artery lesions and the degree of ischemic mitral regurgitation.Material and methods. A retrospective analysis of the results of the examination of 86 patients with various forms of ischemic heart disease in combination with ischemic mitral regurgitation, operated in the department of cardiovascular surgery of the P.V. Mandryka Central Military Hospital. Results. 89,5 % of patients showed multifocal atherosclerotic coronary artery lesions, requiring direct myocardial revascularization; the predominant type of coronary blood supply was right (82,6 %); the average number of affected main coronary arteries was 2,2±1,1, the average total degree of coronary artery lesion was 42,3±25,1 %.Conclusion. 1. The connections between the degree of ischemic mitral regurgitation and the severity and localization of coronary artery lesions was not revealed. 2. The degree of ischemic mitral regurgitation determined primarily by the progression of ischemic remodeling of the left ventricle. 3. Coronary angiography data cannot be a criterion for determining the degree of ischemic mitral regurgitation, however, they are necessary for determining the surgical tactics of direct myocardial revascularization.