Coronary artery disease is the leading cause of death in Europe and in the US and angina is the most common symptom associated with stable coronary artery disease. Despite receiving optimal antianginal therapy, based on agents such as beta-blockers, calcium channel antagonists and nitrates, many patients continue to experience angina. Furthermore, the administration of these drugs is limited by adverse effects such as bradycardia or hypotension. Ranolazine is a new antianginal agent, recently approved as add-on therapy in patients with stable angina. This review will focus on its mechanism of action, tolerability, highlighting the clinical benefit coming from its use.