Secondary prevention for ischaemic heart disease can be defined as a comprehensive set of measures, aiming to reduce the recurrence of cardiovascular disease and to improve long-term prognosis. Despite its proven efficacy, uptake and adherence rates remain poor. This paper summarises the available European recommendations for secondary prevention in varying ischaemic heart disease populations, including those patients with specific co-morbidities. The scientific evidence supporting these recommendations is provided. The article relates to the European Association of Preventive Cardiology, the Acute Cardiovascular Care Association and the Council on Cardiovascular Nursing and Allied Professions Secondary Prevention After Acute Myocardial Infarction framework in that it clarifies accurately who needs secondary prevention.