Background: Off-pump coronary artery bypass grafting (OPCAB) is believed to limit inflammatory reaction. Neutrophil to lymphocyte ratio (NLR) is one of the more common and easily accessible markers of inflammatory response. The aim of the study was to compare postoperative results of NLR with mid-term OPCAB results. Methods: In total, 224 patients (198 (88%) men and 26 (12%) women) with mean age 65 +/− 9 years who underwent OPCAB though median full sternotomy in our department in 2018 enrolled into the study. We scrupulously collected the postoperative mid-term results, including survival rate, clinical status and risk for major adverse events, and compared them with perioperative laboratory results. Results: A three-year follow-up was completed by 198 individuals (90% survival rate) with 12 (5%) showing major adverse cardiovascular (MACE) events risk. In the multivariable analysis, the laboratory parameters noticed on the 1st postoperative day were statistically significantly predictive of survival, including neutrophils (HR 1.59, 1.33–1.89 95%CI, p
< 0.0001), platelets (HR 1.01, 1.01–1.01 95%CI, p
= 0.0065), NLR (HR 1.47, 1.3–1.65 95%CI, p
< 0.0001) and postoperative ejection fraction (HR 0.9, 0.87–0.95 95%CI, p
< 0.0001). Conclusions: Postoperative NLR above 4.6, as an inflammatory reaction marker, is related to mid-term mortality in OPCAB patients.