 Nonsteroidal anti-inflammatory drugs, NSAIDs, are used for chronic pain and inflammation in arthritic conditions, as well as acutely as analgesics by many patients. The therapeutic and adverse effects of NSAIDs are due to inhibition of the cyclooxygenase, cox, enzyme. NSAIDs can be classified as nonselective or cox, two selective inhibitors, coxibs, but both types have been linked to gastrointestinal, G.I., side effects, particularly on the lower G.I. tract. Rolfcoxib, a coxib that was withdrawn due to cardiovascular side effects, has previously unpublished data suggesting questionable G.I. sparing properties. The major side effects of NSAIDs are G.I. complications, renal disturbances, and C.V. events. While it is believed that all NSAIDs are associated with renal and C.V. side effects, lower doses of some NSAIDs may be cardioprotective. This review discusses the G.I. toxicity of NSAIDs and assesses their renal and C.V. adverse effects in detail. This article was authored by Sam Hariforush, Waheed Iskar, and Fakretin Jamali. We are article.tv, links in the description below.