High sensitivity C-reactive protein is inflammatory marker having predictive value in both stable and unstable angina as well as in the acute phase after coronary artery bypass grafting. Many studies have evaluated the prognostic value of CRP for predicting post-operative outcome, most have focused on pre-operative CRP levels, which cannot reflect the inflammatory reactions induced by surgery itself. Here author hypothesized that post-operative CRP elevation, reflecting surgery-induced inflammatory reactions, is related to the occurrence of post-operative major adverse cardiovascular and cerebral events (MACCE) in patients undergoing off-pump coronary artery bypass surgery (OPCAB). Objective: To better understand the current state and application of high sensitivity C-reactive protein (hs-CRP) in clinical practice. To establish excellence of hs-CRP level as a prognostic marker in low EF heart patients. We have done prospective observational study in peri-operative period of 100 patients with stable ischemic heart disease and left ventricular dysfunction (EF < 35%) who underwent off pump CABG to ascertain whether an activation of the inflammatory system during surgery, detected by elevated serum hs-CRP, has any association with prognosis. Result: In patients with pre-operative hs-CRP ≥ 1.0 mg/dl, the cumulative event incidence was 38% compared to 15% in patients with levels pre-operatively of hs-CRP less than 1.0 mg/dl. Post-operative hs-CRP has no significant difference. Conclusion: Author conclude that increased pre-operative hs-CRP > 1.0 mg/dl predict in hospital cardiac and cerebrovascular morbidity and mortality. There is increase in post-operative hs-CRP but it is not statistically significant to conclude it as prognostic marker for predicting post-operative morbidity.