In spite of major advances in the diagnosis and treatment of cardiovascular diseases, they remain the primary cause of death worldwide. Furthermore, the burden of disease is increasing steadily, particularly in emerging countries. Inappropriate prescription, unaffordable cost of medication, and lack of adherence to treatment all contribute to the failure of cardiovascular prevention. In addition, identification of patients at high risk of new ischemic events by means of the available scores is relatively inefficient, as most events occur in individuals with only modest elevations of risk factors. The concept of a fixed-dose combination or “polypill” has emerged recently as a potential strategy for improving cardiovascular disease burden. It is argued that such an approach will make unnecessary patient identification while reducing cost and improving adherence to medication. Several polypills are being developed and some of them are undergoing clinical testing.