Clinical trials have not yet produced long-term primary prevention data on the effects of angiotensin converting enzyme inhibitors, calcium antagonists or alpha-blockers on cardiovascular complications and sudden death in hypertensive patients. Large-scale secondary preventive studies on calcium antagonists have been disappointing. In contrast, beta-blockers have an established role in cardioprotection both in primary and secondary preventive studies and there is evidence to show that the cardioprotective effect of beta-blockers is even greater in the diabetic population. Furthermore, this favourable impact of beta-blockers was achieved despite diabetic patients having a worse risk factor profile and poorer prognosis. In this review the use of beta-blockers in diabetic patients will be discussed and their impact on coronary artery disease described.