Gene therapy (GT) is one of the most fascinating consequences of the penetration of molecular biology and genetic engineering into medicine. Originally, it was assumed that monogenic genetic diseases will be the main field of its application. However, a great majority of the GT-based clinical trials in the last decade have dealt with acquired diseases. Still, its introduction into clinical practice is associated with serious problems. The main obstacle preventing a more rapid development in the field of GT is the imperfection of the vectors presently being used for gene transfer. At the present time, GT is predominantly being used in oncology where the barriers against its employment are weaker than in other medical disciplines. Among the acquired diseases, which are now in the focus of interest of GT, are also cardiovascular diseases. A number of different GT strategies have been developed. Their choice primarily depends on the disease to be treated. In addition to technical and strategic problems, ethical issues play a significant role in planning and performance of clinical studies.