Secondary prevention constitutes a key element in the management of coronary artery disease. In the subgroup of patients with prior coronary interventions, however, secondary prevention plays a distinct role derived from its effects on vessel native atherosclerosis progression, saphenous vein graft attrition and reduction of adverse events after percutaneous revascularisation. From this point of view, secondary prevention can be understood as a protective measure against repeat revascularisation. These benefits contrast with the yet suboptimal implementation of secondary prevention in clinical practice, stressing the importance of a comprehensive approach to coronary revascularisation.