The role of emergency coronary angiography after cardiac arrest and return of spontaneous circulation is not yet completely clear. While patients with a high risk of acute coronary lesion and with a presumed favorable neurological outcome should undergo a coronary angiography as soon as possible, the decision to perform it is questionable in patients who are less likely to have a coronary cause of arrest, and when clinical characteristics raise serious concerns regarding neurological outcome. In this paper, we analyze the main advantages and drawbacks of a coronary angiogram after a successfully resuscitated cardiac arrest.