Knowledge of the etiology, pathogenesis, clinical manifestations, diagnosis, and treatment of coronary artery disease (CAD) has grown considerably. It remains the responsibility of the primary care provider not only to recognize patients with cardiac chest pain but also to identify and treat risk factors associated with CAD in asymptomatic patients. The three major arterial distributions include the right coronary artery (RCA), the left anterior descending artery (LAD), and the left circumflex artery (LCx). Endothelial injury is the inciting event in the generation of luminal stenosis. The diagnosis of CAD is based on a careful, skillful clinical history. The patient should be assessed for a history of CAD risk factors, including diabetes mellitus, smoking, hypertension, hyperlipidemia, and family history of CAD. Pharmacological therapy works, in part, in reducing CAD risk from hypertension, dyslipidemia, and diabetes.