Introduction: Candesartan cilexetil is one of the most often-used first-line drugs regarding the management of arterial hypertension. Moreover, this drug has proven its effectiveness in chronic heart failure and exerts beneficial effects in diabetes, stroke, dementia and atrial fibrillation. Areas covered: This review focuses on the use of candesartan cilexetil in Phase II and Phase III trials and their implications for clinical usage in the treatment of arterial hypertension and heart failure. The usage of candesartan cilexetil in patients with stroke, migraine or atrial fibrillation, hypertrophy obstructive or nonobstructive cardiomyopathy and diabetic or non diabetic renal diseases will be discussed. Relevant publications were identified by an extensive Medline search. Expert opinion: Candesartan cilexetil is a highly effective ARB for the treatment of arterial hypertension and heart failure. Also, recent trials have suggested beneficial effects in diabetic patients, patients with nondiabetic renal diseases, stroke, migraine and atrial fibrillation.