A 40-year-old male pedestrian was hit by a truck and was admitted with multiple injuries including blunt chest trauma. Electrocardiogram revealed acute anterior ST-segment elevation and myocardial infarction. Coronary angiography demonstrated acute ostial left anterior descending coronary artery dissection. Due to extent and location, the lesion was not amenable for angioplasty. Multiple associated injuries and severely impaired coagulation studies directed us to perform emergency off-pump coronary artery bypass grafting.