A positive family history is frequently reported by patients with coronary artery disease (CAD) or myocardial infarction. For risk stratification, it is crucial to distinguish between accidental reoccurrence of sporadic cases and cases with a true heritable component of the conditions. A familial predisposition is assumed when a myocardial infarction is diagnosed by a male first degree relative before the 55th year of life or a female first degree relative before the 65th year of life. The current manuscript reviews major studies from which a familial risk of CAD or myocardial infarction can be inferred. Moreover, a brief overview summarizes the current results of molecular genetic research on chromosomal loci and genes relevant for CAD and myocardial infarction.