Nonsteroidal anti-inflammatory drugs (NSAIDs) include the nonselective and the cyclo-oxygenase-2-specific inhibitors. These agents are used for pain associated with musculoskeletal conditions. The nonselective anti-inflammatory drugs are still widely used, and are also freely available as over-the-counter analgesics. However, they carry the risk of serious cardiovascular adverse effects, especially in patients who have a high, pre-existing cardiovascular risk profile. It is imperative that physicians are aware of these risk factors and choose agents that have the best benefit-to-risk profile, while taking into consideration the patient's individual risk profile. © SAAFP.