Antiplatelet therapy is widely used with proven benefit for the prevention of further ischemic complications in patients with coronary heart disease and stroke. Treatment guidelines for acute coronary syndrome and percutaneous coronary intervention now recommend the use of oral antiplatelet agents including clopidogrel in combination with aspirin (dual antiplatelet therapy: DAPT) for the prevention of recurrent ischemic events. The limitations of DAPT with clopidogrel include the potential for low response to clopidogrel identified through platelet reactivity or genetic testing, or slower return to normal platelet activity in patients who received clopidogrel prior to emergent or planned surgical procedures. This review will discuss the pharmacologic properties and clinical studies about new antiplatelet drugs including prasugrel, ticagrelor and PAR-1 inhibitors.