Coronary artery disease (CAD) is the leading cause of death in the UK. The objective of this study was to readdress the economic burden of CAD in the UK, with the ultimate aim of providing a reliable and up-to-date estimate of the economic cost to society of CAD in the UK. We estimated the cost of CAD in the UK using a prevalence-based 'top down' approach. We took a societal perspective by including both direct healthcare costs and indirect costs. The total direct healthcare cost of CAD in the UK in 2001 was estimated to be approximately 㱮8 billion. The largest cost components were drug treatment (70%) and hospital treatment (25%). Friction-adjusted indirect costs of CAD borne by society in the UK are estimated to be 㷰2 million, or approximately 28% of the overall costs of CAD. Our study illustrates the impact of recent changes in drug treatment for CAD, and has shown that CAD has a relatively small share of total NHS expenditure considering that CAD is the leading cause of death in the UK. This suggests that new medical interventions are required for CAD, with sufficient efficacy and cost-effectiveness to justify a greater share of NHS resources.