Paul Strumph, Rick Turner and Associates at Quintiles introduce a new Commentary Series entitled Lessons Learned in Developing Cardiovascular and Metabolic Drugs, that will appear in each issue of this journal. The goal of these papers is to provide readers with pragmatic information and insights that will facilitate well-informed decisions at critical “forks in the road” during preapproval clinical development programmes for cardiovascular and metabolic drugs. The commentaries will focus on specific challenges in clinical development, prioritised scenarios developed to succeed, outcomes, and lessons learned.