Caffeine is the most popular and widely-consumed behaviourally-active substance in the world. This review focuses on the influence of caffeine on the cardiovascular system, with a special focus on blood platelets. For many years, caffeine was thought to have a negative effect on the cardiovascular system mainly due to increasing blood pressure. However, more recent data suggests that habitual caffeine consumption may reduce the risk of cardiovascular disease and hypertension. This could be a significant finding as cardiovascular disease is the leading cause of death worldwide. Caffeine is known to inhibit A1 adenosine receptors, through which it is believed to modulate inter alia coronary blood flow, total peripheral resistance, diuresis and heart rate. Although few publications have reported the effects of caffeine on platelet function, it seems reasonable to conclude that caffeine has antiplatelet activity. Platelet activation is known to play a crucial role in the development of arterial thrombotic diseases such as coronary heart disease and stroke, and hence there is a need to develop novel platelet inhibitors. One promising strategy to develop effective antiplatelet therapy involves targeting multiple pathways of platelet activation. Therefore, this review also examines the concept of dual antiplatelet therapy and the potential benefits associated with the therapeutic use of combined P2Y12 antagonists and adenosine receptor agonists in cardioprotection.