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▸ The role of CAs in current clinical guidelines is discussed. ▸ Clinical trials with CV outcome and meta-analyses support CA usage in CAD. ▸ CAs are effective in overall management of CV risk factors and disease states. ▸ CAs have pleiotropic effects that are useful in managing CAD.The role of calcium antagonists (CA) in coronary artery disease (CAD) treatment was previously limited due to increased adverse cardiovascular events associated with rapid release, short-acting CAs. However, many large scale randomized clinical trials as well as meta-analyses have confirmed safety of long-acting CAs and documented either benefit or equivalence regarding cardiovascular outcomes versus the comparator agents in patients with or at risk for CAD. Furthermore, CAs are metabolically neutral, well tolerated, and poses pleiotropic effects that could work alone or in combination with other risk factor modifying agents for beneficial overall risk management. Therefore, CAs may be ideal for managing CAD and may be considered as a first-line treatment option, depending on individual patient characteristics.