Atherosclerosis and its cardiovascular complications remain the leading cause of death in developed countries. Current knowledge of coronary artery disease progression has significantly evolved and the interest has been focused on the development of new imaging techniques for the early detection of vulnerable lesions. Intracoronary thermography is a method that detects local plaque inflammation. Clinical studies with intracoronary thermography have enlightened the diagnostic algorithm of high-risk or "vulnerable" plaque. The current shortcomings, however, of intracoronary thermography limit the clinical application of the method. Future technological achievements will hopefully lead to the detection of inflamed plaques, thus determining the role of inflammation in plaque destabilization and directing local and/or systemic therapy in patients with coronary artery disease.