Coronary artery disease and cancer may sometimes co-exist in elderly patients. For patients who require surgery,treatment strategy is always an issue. Prompt attention to the cancer is a high priority, while implementing the least invasive way to treat both diseases, if possible. We report a case of a 79-year-old woman with gastric cancer and multi-vessel coronary artery disease, where gastric cancer was successfully treated with perioperative use of intra-aortic balloon pumping (IABP), followed by percutaneous coronary intervention (PCI) with drug-eluting
stents (DES). This combination may be an effective approach for physically debilitated patients with severe coronary artery disease who require major non-cardiac surgery.