Coronary heart disease is the leading cause of mortality for adult women in the United States, accounting for the death of nearly 250,000 women each year. Once coronary disease becomes clinically evident, it causes prominent morbidity and disability in women, particularly among older women. Women are more likely to die from an episode of myocardial infarction than are men, and first-year mortality following myocardial infarction is comparably greater for women. Similarly, women do not fare as well as men following myocardial revascularization procedures, having a greater mortality from coronary artery bypass graft surgery, less graft patency, less symptomatic relief, and more reoperation within the initial postoperative 5 years. Despite initial favorable outcomes from percutaneous transluminal coronary angioplasty, women have less long-term symptomatic relief and decreased long-term survival, the latter, however, predominantly related to their older age. The increased case fatality rates and greater morbidity of women following both myocardial infarction and myocardial revascularization procedures underscore the need for preventive interventions for women across their life span. Dramatic strides have been made in recent years, based on the recognition of the importance of coronary heart disease as a health problem for women. There is an increased emphasis on coronary preventive strategies, improvement in the prompt evaluation of chest pain syndromes, and increase in the performance of myocardial revascularization when appropriate; research is also under way to assess risk interventions unique to women.