Background: Acute kidney injury is a well-known complication after surgical or percutaneous coronary revascularization, Few publications have directly compared its risk in both techniques. Aim: to compare the incidence and predictors of acute kidney injury after revascularization either by CABG or PCI Methods: This is a prospective, observational, non-controlled study included 300 patients presented to National Heart Institute from December 2014 to November 2015 with Multivessel CAD. All patients were subjected to demographic data analysis, clinical examination, echocardiography, baseline laboratory investigations and syntax score calculation. Follow up of kidney function by serum creatinine and eGFR within 48 hours. Results: acute kidney injury occurred in 22 % in CABG group, versus 9.3% in PCI group (P = 0.003). Hemodialysis was needed in one patient in CABG group vs no patients in PCI Group (p = 0.511). Multivariate logistic regression analysis showed that Older age (P = 0.010) , increased BMI (P =0.037) , dilated LV ( P = 0.049), lower Ejection Fraction (P = 0.049 ) and blood transfusion (P