We report a case of combined off-pump coronary artery bypass grafting (OPCAB) and living-donor liver transplantation (LDLT). Patient was admitted to undergo liver transplantation due to Child C cirrhosis secondary to hepatitis B infection, and incidentally, his preoperative cardiac evaluation revealed silent ischemia due to the two-vessel coronary artery disease (CAD). Patient underwent OPCAB followed by LDLT. There was no perioperative cardiovascular event during the days of hospitalization. From the successful anesthetic experience of a combined OPCAB and LDLT, we cautiously suggest that a combined OPCAB and LDLT could be a surgical treatment for the patients with end-stage liver disease (ESLD) and advanced CAD.