Several recent papers have documented the increased risk of adverse neurological outcome associated with age in elderly patients undergoing coronary artery bypass surgery. Further evidence favouring cerebral microemboli as a primary mechanism of cerebral injury after coronary artery bypass surgery has been presented. Improved neurobehavioural outcomes with alpha-stat management during cardiopulmonary bypass have now been shown in several papers. Hypothermic circulatory arrest and the role and limitations of retrograde cerebral perfusion are also evaluated.