C-reactive protein (CRP) is a marker of inflammation that, along with low density lipoprotein cholesterol, has become the best predictor of future cardiovascular events. CRP is easy to measure, and patients and physicians can readily grasp its interpretations. Coupling the measurement of CRP with a lipid panel yields the best predictor of cardiovascular risk assessment currently available. The reason for CRP's superiority in cardiovascular risk prediction may be attributed to its proatherogenic property because CRP can activate endothelial cells and smooth muscle cells. The author has recently demonstrated that CRP can be produced by vascular smooth muscle cells in response to inflammatory cytokines. Thus, CRP can be produced in the vascular wall and directly exerts its proatherogenic effect locally.