Background and Objective: A linear correlation was shown between the occurrence of coronary artery disease (CAD) and radiation dose received by coronary arteries for Hodgkin’s lymphoma (HL) patients, derived by mean heart dose/long-term follow-up datasets. The purpose of this study was to delineate coronary arteries and optimize radiation planning on these substructures by using an optimized multi-arcs volumetric arc therapy (VMAT) solution, then to compare it to standard 3D-CRT with the aim of showing a potential dosimetric benefit for VMAT. Materials and methods: We compared the plans of 14 HL patients (3 males and 11 females) with stage I-IIA mediastinal disease without axillary involvement, treated with involved site radiotherapy (ISRT); 11 had a bulky presentation at diagnosis. In every patient, a deformable fusion was performed with a dedicated software between the planning CT and the pre-ISRT contrast enhanced CT scan. The following structures were delineated: whole heart; left main, left descending, circumflex and right coronary arteries; aortic, pulmonary, mitral and tricuspid valves; right and left atria; right ventricle, left ventricle and interventricular septum; left ventricular apex, mid cavity, base and lateral wall. Two experienced radiation oncologists contoured target volumes (CTV), and heart substructures, after a validation session with a cardiologist and a heart radiologist. The VMAT approach consisted of multi non-coplanar arcs (the so-called “butterfly” VMAT or B-VMAT) and was compared with 3D-CRT. Mean and max dose received by the coronary arteries were compared by Student’s T test. Results: Maximum doses to coronary arteries resulted similar; conversely, lower mean doses were delivered by using B-VMAT, reaching a significant difference for the left main trunk (p = 0.002), the circumflex coronary artery (p = 0.014) and the right coronary artery (p = 0.002). Most significant findings are illustrated by the table and box-plots. Discussion: This study suggests that an optimized intensity modulated RT solution (B-VMAT) is able to reduce the dose to coronary arteries for HL patients with mediastinal disease. As the dose-response relationship is linear, this reduction should translate in lower incidence of CAD.