There is considerable controversy about whether patients with cardiovascular disease should be screened for depression. Depression is known to be associated with increased morbidity and mortality, but screening by itself does not improve either depression or cardiovascular outcomes. Nonetheless, depression deserves treatment regardless of its cardiovascular effects, and screening plus collaborative care is cost effective in primary care settings. Thus, patients with cardiovascular disease should receive routine screening for depression by primary care providers in the context of a collaborative care treatment program.