It is well established that South Asians living in the western world have a higher burden of cardiovascular disease than other ethnicities. Additionally, South Asians develop cardiovascular disease at a younger age, have a more aggressive form of coronary artery disease, and a higher overall mortality. This predilection seems to be multifactorial and includes a combination of traditional and emerging risk factors with an absence of ethnic-specific prevention and control measures. Future direction points toward ongoing research with the aim of discovering technology for earlier detection. Additionally, coronary artery disease in South Asians could be addressed by increasing awareness, modifying health beliefs through health-promotion strategies, and instituting ethnic-specific control measures including appropriate and early pharmacological intervention.