Aim. Coronary artery bypass grafting (CABG) is the most commonly performed cardiac surgery globally. The aim of the study is to investigate outcome of CABG according to participant sex in the real word. Methods. We retrospective analysed 20337 CABG operations performed in an Italian Region, Lazio, using a regional administrative dataset. Results. Between 2008 and 2022, 16983 male and 3354 female patients underwent CABG and were analysed. At baseline male patients had lower left ventricle ejection fraction (LVEF <30% 3.52% vs 2.68; 30<LVEF<50 34.19% vs 31%; LVFE >50% 62,2% vs 66,2%, p<0.0001) but with a lower risk profile: female patients were older (70+9 vs 66+9.5 yo, p<0.05), more diabetics (28 vs 20%, p<0.0001), cholesterol disorders (20,5% vs 17.6%, p<0.0001), obesity (2.6 vs 1.6%, p<0.0001), anemia (3.6 vs 1.7 % ,p<0.0001), arterial hypertension (43.3 vs 36.6%, p<0.0001) and heart failure symptoms (10,1 vs 7,1%, p>0.0001). Even if early mortality (30d) was higher in female vs male patients (3.1% vs 1.9%, p<0.05), long term survival was higher in women at 5 and 10y respectively 88 vs 87% and 73 vs 70%. Conclusions. Our data suggest that female sex could be associated to an higher profile risk and 30d mortality after CABG but in the long term could be protective.