Coronary artery disease affects millions of Americans and is a major cause of global morbidity and mortality. Detection and optimal treatment strategies are needed to reduce the clinical and economic burden of this disease. Chest pain history, risk factor profile, and noninvasive stress test results are used for clinical risk stratification. In high-risk patients, coronary angiography is the standard for anatomic diagnosis and additional risk stratification. All patients with coronary artery disease should be treated with optimal medical therapy. Patients with uncontrolled symptoms or high risk for adverse outcomes benefit from coronary artery revascularization with percutaneous coronary intervention or coronary artery bypass graft surgery.