Objective To analyze the advantages and disadvantages of two surgical Methods for treatment of lung cancer complicated with coronary heart diseases (CHD), so as to provide evidence for clinical practice. Methods Nine patients with lung cancer complicated with CHD received radical resection of lung cancer shortly after percutaneous coronary intervention (PCI) with stent implantation from Dec. 2010 to Dec. 2011 in the General Hospital of PLA. During the same period eight patients with lung cancer and severe coronary artery stenosis underwent off-pump coronary artery bypass grafting (OPCABG) and radical operation for lung cancer in the Third Hospital of Peking University. The clinical data of the two groups (PCI group and OPCABG group) were analyzed and compared. Results There were no perioperative myocardial infarction, pulmonary infection, incision infection, reoperation due to bleeding, or perioperative death in both groups. Compared with the PCI group, OPCABG group had significantly longer overall operation time ([428±22] min vs [149±32] min), more blood loss ([367±19] ml vs [171±19] ml), and more chest drainage in the first postoperative 24 hours ([527±17] ml vs [250±14] ml, P<0.01). The operation time for lobectomy ([158±27] min vs [149±32] min) and postoperative hospital stay ([10±0.5] d vs [11±0.5] d) were not statistically different between the two groups. Conclusion Coronary intervention and coronary artery bypass grafting have their own advantages in treating lung cancer complicated with severe ischemic heart disease. Appropriate revascularization techniques should be chosen according to indications before radical operation for lung cancer, while considering the patients’ physical condition and specific site of coronary lesions.