Background: Reduction of Atherothrombosis for Continued Health (REACH) is the world’s largest registry designed to obtain information on the control of vascular disease risk factors (VDRF) and preventive treatment. Methods: 67,888 patients with symptomatic atherothrombosis or a high risk of developing the disease have been recruited from 5,473 outpatient clinics of 44 countries. Results: Of those in the REACH registry, 82% are patients in secondary prevention, and 27% have cerebrovascular disease (CVD). As with the rest of the patients, the control of VDRF in patients with CVD is poor and needs improvement. The characteristics of the Spanish patients do not differ significantly from the rest of the subjects in the registry. Conclusion: The registry carries information not only on the characteristics of patients with CVD and their therapeutic management, but also on the incidence of new vascular complications as well as on the effectiveness of different therapeutic strategies in preventing new complications in standard clinical practice.