Background This study assessed the neurologic and cosmetic outcome of the endoscopic radial artery harvesting (ERH) technique in coronary artery bypass grafting (CABG). Methods and Results The study group comprised 257 consecutive patients who underwent CABG between January 2001 and August 2005 at Kyungpook National University Hospital. The first 157 patients (open group) underwent conventional open harvesting of the radial artery and the second 100 (endoscopic group) had endoscopic harvesting. The severity of both the motor and sensory symptoms, as well as the cosmetic results, was evaluated immediately and at least 6 months after surgery. In the open group, 29 patients experienced neuralgia along the distribution of the lateral antebrachial cutaneous nerve, but none in the endoscopic group patients experienced any sensory abnormalities (p<0.05). However, neuralgia along the distribution of the superficial radial nerve was similarly observed in both groups. No one in either group complained of any motor symptoms. The patients in the endoscopic group were also satisfied with the cosmetic results. Conclusions ERH resulted in less neurologic complications of the hand and forearm, and outstanding aesthetics. ERH may be the procedure of choice for radial artery harvesting. (Circ J 2007; 71: 1511 - 1515)