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The review is devoted to ivabradine – the first If selective and specific inhibitor, reducing heart rate (HR). It is well known that HR is an independent risk factor, increasing incidence of all-cause, sudden, and cardiovascular death. Ivabradine specifically and dose-dependently binds to f-channels of sinus node cells, inhibits them, and facilitates HR reduction at rest or during maximal physical workload, without affecting mean blood pressure. In three large clinical trials, ivabradine was well-tolerated and demonstrated substantial antianginal and antiischemic effectiveness, at least similar to that for modern antianginal medications – beta-blockers or calcium antagonists. Therefore, ivabradine could be regarded as alternative to modern antianginal medications, in case of contraindications to or adverse effects of standard therapy.