Despite the reduction in perioperative mortality observed over the past two decades, the risk of performing cardiac surgery in patients with coronary artery disease and severe left ventricular dysfunction remains high, These risks have led to the appearance of several ways to provide better outcomes. These ways are either mechanical like intraaortic balloon pump (IABP) or using medical inotropic drugs either adrenergic (epinephrine, norepinephrine &dobutamine) or nonadrenergic (levosimendan) drugs. It is indicated for the short-term treatment of acutely Patients and Method Patients had collected, evaluated thorough the preoperative, intra-operative, postoperative period withpoor left ventricular function ejection less than or equal to 40%. Cases had allocated into two gatherings of 50 cases.cases had admitted to the cardiovascular intensive care unit (ICU) 24h before surgery, a peri-operative dose of continuous levosimendan infusion over a total of 24h in the other gathering, cases will be submitted to conventional inotropes only (non levosimendan gathering) according to their medical requirements. Objective: the aim of this study had to detect the outcome of clinical use of preioperative Levosemindan for cases undergoing coronary artery bypass grafting with poor left ventricular function, also comparing it with the conventional medications as catecholamines. Results Gathering A included 38 cases received levosimendan as perioperative cardiac support Gathering B included 40 cases received conventional cardiac support. A critical difference between both gatherings regarding total operative time, total bypass time, failure of weaning from cardiobypass (C.P.B), the use of intraoperative I.A.B.P.. There had a statistically critical difference between both gatherings in which C.V.P had lower in levosimendan .There had statistically critical difference regarding base critical in the levosimendan gathering. with high statistical difference for medical support, no difference for support . Conclusion the use of levosimendan perioperatively decrease the operative time, cross clamp time, facilitate the weaning from cardiomachine decrease the need of conventional inotropic support, decrease the duration of postoperative ventilation, improve the tissue perfusion, cardiac output parameters, length of I.C.U, hospital stay with decreasing early postoperative mortality, it had high degree of drug safety, tolerability