Patients with end-stage renal disease (ESRD) and coronary heart disease have a very high risk of cardiovascular mortality. We describe results of recent studies on prevention and treatment strategies. Although the outcomes of revascularization methods, i.e. coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), in ESRD patients are worse than in the general population, CABG and PCI significantly improve survival of the ESRD population. The studies suggest more favorable results with CABG compared with PCI. Patients with a kidney transplant and coronary artery disease (CAD) have better prognosis. In this population, the long-term results of revascularization (CABG and PCI) are comparable. Studies should be focused on optimizing and individualizing revascularization methods, preventing restenosis after PCI, and improving invasive cardiology techniques and anti-aggregation treatments.