Currently, myocardial unroofing, coronary artery bypass grafting and percutaneous coronary intervention are chosen as treatments for myocardial bridge. We performed a male patient off-pump unroofing of left anterior descending coronary artery with techniques of minimally invasive surgery through the 4 th intercoastal space. Intraoperative coronary angiography was performed to evaluate residual lesions. Since this treatment strategy does not require full heparinization, it can be expected to reduce the amount of bleeding. This procedure not only has small incision, but also has some major advantages.