A 75-year-old man with situs inversus totalis, presented to our hospital complaining of chest pain. ECG showed ST depression in the leads of Ⅰ, aV L , V5, and V6. Blood tests showed cardiac enzyme (Troponin I)elevation. Coronary angiography revealed severe calcification and stenosis of the anatomical left anterior descending artery (LAD), and the anatomical right coronary artery (RCA). The Patient underwent coronary artery bypass grafting (CABG) using the right internal thoracic artery and saphenous vein graft. The postoperative course was uneventful. CABG in a patient with situs inversus totalis is very rare. We present this case with a review of the relevant literature. Jpn. J. Cardiovasc. Surg. 51 : 21-24 (2022) Keywords: situs inversus totalis ; dextrocardia ; coronary artery bypass grafting (CABG)