The radial artery has increased in popularity as a conduit for use in coronary artery bypass surgery. However, concerns remain regarding the risk of radial artery spasm. Although the use of different pharmacological agents to prevent and treat this has been described, there is currently no clear agreement as to the optimal agent. To clarify which agents are most suitable for clinical use, all pertinent studies to date (January 2007) that have reported the efficacy of pharmacological agents in the prevention and treatment of radial artery spasm have been reviewed. It can be argued that verapamil-glycerine tri-nitrate solution represents the optimum agent when used in the perioperative period.