Angina is the clinical manifestation of myocardial ischemia and is most often due to coronary stenosis. The management of stable ischemic heart disease requires treatment aimed at both symptom relief and reduction of cardiovascular morbidity and mortality related to atherosclerosis. Risk-factor modification and medical therapy to prevent acute ischemic events and disease progression should be initiated after diagnosis. Patients with symptoms refractory to medical therapy, high-risk stress test results, or anatomic findings have an indication for coronary revascularization. This article addresses evidence that supports the use of secondary prevention therapies and the various antianginal medications that are available for the management of stable angina.