The first major trial to look at the cardioprotective effects of hormone replacement therapy (HRT) has provided firm evidence that HRT reduces cardiovascular risk in postmenopausal women. With the results of this trial in hand, physicians will be able to make more informed decisions regarding the use of HRT in their patients. Considerable controversy has haunted HRT since its introduction in the 1950s, as little evidence was available regarding its risks and benefits. Although the recent PEPI trial does not provide all the answers, it has begun to resolve several uncertainties, providing a platform for future studies. The results of the trial were presented at the 67th Scientific Sessions of the American Heart Association (AHA) [Dallas, US; November 1994].