Current opinions regarding the prevalence of coronary artery disease in black Americans are conflicting. Some physicians believe that the prevalence of coronary artery disease in black Americans is less than that in the general population; some find no difference; still others argue that the high prevalence of risk factors, such as hypertension, should result in a higher prevalence of coronary artery disease in black Americans. This article will not attempt to resolve these conflicts but instead will review some of the medical literature that may have influenced prevailing opinions.