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Background: Recent evidence suggests that skeletonization of the left internal mammary artery (LIMA) can improve the flow and length of the flow, reduce deep sternal infections and postoperative pain. Objectives: The present study aimed to investigate the effect of two LIMA harvesting techniques (skeletonization and pedicled) on postoperative pain and bleeding. Methods: This randomized double blind clinical trial study on patients undergoing LIMA harvest in Birjand was conducted dur- ing years 2012 to 2014. The patients were divided to two (skeletonization N: 30 and pedicled N: 30) groups according to the LIMA harvesting method. Their demographic information and other relevant data were collected by means of a questionnaire. Results: In total, 60 cases, who were candidates for coronary artery bypass grafting (CABG) at the cardiac surgery department of Valiasr hospital in Birjand, were studied. In the skeletonized group, the conduit length was significantly longer (17.96 vs. 17.27, P < 0.001), yet there was no significant difference between early and mid-term pain scores (P values: 0.32 and 1.0, respectively) and early postoperative bleeding (782.26 vs. 903.16, P = 0.657). Conclusions: The IMA skeletonized collection resulted in the reduction of postoperative pain and increased conduit length. Skele- tonization could not decrease postoperative bleeding.