Background: Anxiety and delayed recovery are common challenges after coronary artery bypass graft (CABG) surgery. Preoperative counseling may improve perioperative outcomes by reducing psychological distress and promoting recovery. This study evaluated the role of preoperative counseling in reducing anxiety, alleviating postoperative pain, stabilizing hemodynamic parameters, and shortening hospital stay in CABG patients. Methods: A randomized clinical trial was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from January 2015 to June 2015. Fifty patients scheduled for elective CABG were enrolled, with 25 assigned to the counseling group and 25 to the control group (routine care). Anxiety was assessed using the State Anxiety Questionnaire, pain was assessed using the visual analog scale (VAS), hemodynamics were monitored perioperatively, and hospital stay was recorded. Data were analyzed using SPSS-19. Results: Baseline demographics were comparable between groups. Postoperative anxiety scores were significantly lower in the counseling group (41.44 ± 4.73) compared with controls (56.20 ± 3.30, p<0.001). VAS pain scores were consistently lower in the counseling group across postoperative days 0–4, with the greatest difference on POD 2 (2.92 vs. 3.96). Counseling also contributed to a more stable heart rate and systolic blood pressure. Mean hospital stay was significantly shorter in the counseling group (10.56 ± 0.50 vs. 12.68 ± 0.74 days, p<0.001). Conclusion: Preoperative counseling reduces postoperative anxiety and pain, enhances hemodynamic stability, and shortens recovery after CABG. Incorporating counseling into routine care may improve surgical outcomes.