The management of chronic stable angina has undergone considerable evolution over the past two decades. This review highlights the need for a comprehensive approach to management, which includes careful identification of cardiac risk factors, use of therapeutic lifestyle interventions (especially in high‐risk patients with diabetes mellitus or metabolic syndrome), aggressive, multifaceted medical therapy, and the judicious use of myocardial revascularization. Traditional anti‐ischemic therapy continues to comprise aspirin, beta‐blockers and calcium channel blockers, along with adjunctive therapies that include statins and ACE inhibitors. Ranolazine is a novel anti‐anginal and anti‐ischemic agent that has promise in reducing refractory ischemia and as add‐on therapy for patients who ischemia cannot be optimally controlled with standard anti‐ischemic agents. The role of coronary artery bypass graft surgery and percutaneous coronary intervention (PCI) in the management of the chronic stable angina patients is discussed, as are the clinical implications of the COURAGE Trial. The combined use of both a “focal” approach (PCI to treat the culprit stenosis) and a “systemic” approach (lifestyle intervention and aggressive pharmacotherapy with comprehensive secondary prevention) may afford the best opportunity to enhance event‐free survival and optimize clinical outcomes in patients with chronic coronary artery disease and stable angina.