Cocaine abuse is an ongoing and serious problem that has led to the growth of a brutal criminal enterprise, particularly in the Americas and Europe. At present, there are no effective pharmacological agents available to treat the addiction by blocking cocaine or reversing its effects. In order to help motivated addicts conquer their addiction, vaccines against cocaine are being developed and one has progressed to clinical trials. This article will discuss the concept of antidrug vaccines in general, the successes and limitations of the various anti-cocaine vaccine approaches, the results of the clinical trials with an anti-cocaine vaccine and some new vaccine-mediated approaches to combat cocaine addiction.