Adenosine is known to exert most of its physiological functions by acting as local modulator at four receptor subtypes named A 1 , A 2A , A 2B and A 3 (ARs). Principally as a result of the difficulty in identifying potent and selective agonists, the A 2B AR is the least extensively characterised of the adenosine receptors family. Despite these limitations, growing understanding of the physiological meaning of this target indicates promising therapeutic perspectives for specific ligands. As A 2B AR signalling seems to be associated with pre/postconditioning cardioprotective and anti-inflammatory mechanisms, selective agonists may represent a new therapeutic group for patients suffering from coronary artery disease. Herein we present an overview of the recent advancements in identifying potent and selective A 2B AR agonists reported in scientific and patent literature. These compounds can be classified into adenosine-like and nonadenosine ligands. Nucleosidebased agonists are the result of modifying adenosine by substitution at the N 6 -, C 2 -positions of the purine heterocycle and/or at the 5′-position of the ribose moiety or combinations of these substitutions. Compounds 1-deoxy-and its 2-chloro analogue 23 (hA 1 K i =3500 nM, hA 2A K i = 4950 nM, hA 2B EC 50 =210 nM, hA 3 K i >5 μM) were confirmed to be potent and selective full agonists in a cyclic adenosine monophosphate (cAMP) functional assay in Chinese hamster ovary (CHO) cells expressing hA 2B AR.Nonribose ligands are represented by conveniently substituted dicarbonitrilepyridines, among which 2-[6-amino-3, 5-dicyano-4-[4-(cyclopropylmethoxy)phenyl]pyridin-2-ylsulfanyl]acetamide (BAY-60-6583, hA 1 , hA 2A , hA 3 EC 50 >10 μM; hA 2B EC 50 =3 nM) is currently under preclinicalphase investigation for treating coronary artery disorders and atherosclerosis.