Non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used drugs. Current evidence supports that all NSAIDs increase the risk of heart failure and elevate blood pressure, whereas the risk of thrombotic events varies with the type of drug. Use of newer selective cyclooxygenase-2 inhibitors has been associated with a substantial vascular risk but increasing concern also relates to traditional NSAIDs, in particular diclofenac. This review summarizes the current evidence regarding the cardiovascular safety of NSAIDs and presents recommendations for their use.