Much has been written in the last few months on the association between the cyclooxygenase-2 (COX-2)-selective inhibitors and cardiovascular events. We summarize the randomized controlled studies of different COX-2 inhibitors that led to rofecoxib withdrawal, provide evidence on the differences between various selective coxibs and summarize recommendations from the FDA and the American College of Rheumatology on use of COX-2 inhibitors. We give suggestions on the use of coxibs and briefly mention a general approach to the future of coxibs.