Hybrid coronary revascularization (HCR) is an innovative approach that combines coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) to optimize treatment outcomes for patients with multivessel coronary artery disease (CAD). This strategy leverages the strengths of both modalities—CABG's durability in addressing complex and diffuse lesions, particularly in the left anterior descending artery (LAD), and PCI's minimally invasive nature, which is effective for non-LAD lesions. HCR has emerged as a viable alternative to traditional CABG or PCI alone, especially in patients where risk factors, comorbidities, or anatomical considerations make single-modality treatment suboptimal. Advances in surgical techniques, stent technologies, and imaging have improved the feasibility and safety of HCR, making it a cornerstone in personalized CAD treatment. Studies demonstrate that HCR offers comparable or superior outcomes in terms of myocardial revascularization, reduced perioperative complications, and shorter hospital stays compared to conventional approaches. It also provides a tailored solution for high-risk patients, reducing the need for cardiopulmonary bypass and enabling quicker recovery times. However, challenges persist, including the need for specialized interdisciplinary teams, timing coordination between surgical and catheterization procedures, and addressing cost-effectiveness. This review explores the current evidence, techniques, and patient selection criteria for HCR, highlighting its role in advancing CAD treatment. Future research must focus on refining protocols, long-term outcomes, and integrating novel technologies to maximize the benefits of this hybrid approach, thereby ensuring optimal patient care and clinical outcomes.