Purpose: Patients requiring coronary artery bypass grafting (CABG) with concurrent large AAA (meeting threshold for repair) present a dilemma. There is controversy with regards to the order and mode of intervention, and whether concurrent surgery should be attempted. This is a systematic review to elucidate aspects of management of such complex patients. Methodology: PubMed, MedLine, Embase and GoogleScholar were reviewed for search terms “aortic aneurysm” AND “coronary artery bypass graft”. All relevant articles were retrieved and reviewed. Results: Eight articles were retrieved, which discussed management of concurrent large AAA and CABG. All articles suggested a mechanism of increased collagenase activity and thus rupture risk with prior CABG. Several treatment modalities were discussed including 1) staged CABG followed by EVAR/open AAA repair; 2) simultaneous CABG and EVAR/open AAA repair; 3) percutaneous intervention followed by EVAR/AAA repair. In all discussed cases, CABG was performed prior to AAA repair due to concern for significant peri-operative cardiac morbidity. The exact time interval for AAA ranged from two to eight weeks. Articles (N=2) discussed role of simultaneous CABG with retroperitoneal AAA repair (with heparin reversal prior). Higher risk for coagulopathy, respiratory complications and mortality have been reported. Conclusion: Concurrent symptomatic coronary artery disease and large AAA presents a dilemma for the modern vascular surgeon. There is an accepted higher risk of rupture post CABG due to production of pro-inflammatory cytokines. A number of options available in modern era of endovascular stent grafting. The exact time interval for intervention is not well elucidated and warrants further investigation.