Despite our longstanding awareness of atherosclerosis and its association with myocardial infarction and sudden cardiac death, only recently have we been able to study the pathology and progression of atherosclerotic plaque formation. Novel methods of imaging the arterial wall have enabled the identification of preclinical disease and plaque progression, as well as better evaluation of therapeutic interventions. Thanks in large part to advances in imaging technology, this deeper understanding of the stages of atherosclerosis progression underscores the importance of primary and secondary preventive efforts. Patients are becoming increasingly sophisticated in their knowledge of health issues and often want to know more about their own illnesses. Unfortunately, a plethora of inaccurate, biased, or incomplete information is readily available through the Internet, television, and print media. So-called advocacy groups claiming to protect the populace against dangerous drugs also amplify the risks of many drug therapies and downplay their benefits, to the detriment of public health. Family physicians play an important role in educating patients about risk factor identification and management and treatment of coronary artery disease. In particular, family physicians can help patients understand the implications and clinical utility of new research findings related to atherosclerosis. The text and figures that follow will review new developments in our understanding of the pathogenesis of atherosclerosis and new ways that changes in atherosclerotic plaque size and volume can be measured.