This issue of Medical Clinics of North America covers everything the internist needs to know about the diagnosis and treatment of chest pain. Topics covered include respiratory causes of chest pain; cardiac causes; gastroenterological causes, such as GERD and dysphagia; musculoskeletal causes, such as fibromyalgia and segmental dysfunction; psychological causes, skin and soft tissue causes, and pediatric chest pain. A detailed master algorithm for diagnosis and management is provided, and future directions are also discussed.