The prevention of sudden cardiac death remains one of the greatest challenges in the field of cardiovascular medicine today. Despite the difficulty in predicting which individuals are going to die suddenly, much knowledge has accumulated in recent years in regard to independent risk factors for SCD and moreover, different pharmacological interventions have been evaluated for the prevention of sudden coronary death. Currently, the beta-blockers are the only pharmacological agents that have been shown to reduce sudden cardiac deaths in clinical trials. The reduction in sudden death may involve several mechanisms that include antiatherosclerotic effects, antithrombotic effects, cardiac anti-ischemic effects and antifibrillatory effects.