A placebo-controlled, double-blind, randomized study found that subjects randomized to the vascular endothelial growth factor (VEGF) gene-receiving treatment group showed a greater level of angina reduction in comparison to control subjects who received saline as a placebo. These data provide hope for a new treatment option for those who are not candidates for invasive therapeutic procedures and are refractory to medical therapy for angina. Furthermore, the findings are important to the areas of therapeutic angiogenesis and gene therapy as a whole. This article discusses VEGF and its brief history as a form of gene therapy in the context of the VEGF gene therapy trial that the American Heart Association has recognized as one of the top 10 scientific advances of 2001.