The role of psychosocial factors in the cause of coronary heart disease (CHD) has been investigated with increasing confidence over recent years, due to a number of developments. Large scale prospective studies of psychosocial factors assessed with standardised measures and using all the rigour of modern multivariate epidemiology have begun to produce results. These have been accompanied by greater sophistication in the identification of the physiological mechanisms through which emotions, behaviour, and the social environment influence disease processes. Distinctive factors may be associated with the long term progression of CHD and with the triggering of cardiac events in vulnerable individuals. Animal studies have also come of age, with older stress paradigms being replaced by observations on more relevant phenomena such as social isolation and social disruption.1This brief summary describes some of the main themes that are emerging in psychosocial research, and their relevance to current clinical practice.