The need for predicting cardiovascular risk in the general population is obvious. Not only are myocardial infarction (MI) and stroke major causes of morbidity and mortality in the Western world, we now known the atherosclerosis to be a pathologic process that arises over decades, even if its most dangerous complications can happen over minutes. As such, it is perhaps not surprising than one-third of all first MIs are fatal, underscoring the need for sensitive clinical predictors of cardiovascular risk. In the absence of applying such tools in patients with no history of cardiovascular disease, many individuals will not survive their initial presentation and go on to receive the many cardiovascular therapies that have proven so successful. Extensive evidence supports the contribution of established risk factors such as hypertension, cigarette smoking, and low density lipoprotein (LDL) levels in predicitng future cardiovascular events. These factors take a prominent part in risk calculators such as the Framingham Risk Score. At the same time, more recent studies have shed light on re-defining the level sof these various established risk factors. Diabetes mellitus is now recognized as a “cardiovascular risk equivalent”, meaning that patients with diabetes should receive risk factor modification as intensively as patients with known cardiovascular disease given their overall risk for cardiovascular events independent of their prior history. Beyond this, attention has also focused on additional markers that might further help risk stratify patients for future events. C reactive protein (CRP), a marker for inflammation, is perhaps the most intensively studied one of these emerging risk factors. It remains unclear if CRP is simply a marker or an actual mediator of atherosclerosis; regardless, the evidence for the predictive value of CRP is  quite strong and continues to grow. It remains to be established how CRP levels will be integrated into clinical practice in a way that adds value or changes management in most cases above and beyond careful assessment of other well-known, well-established risk factors.