Despite a developed understanding of the pathophysiology of cardiovascular disease and the existence of evidence-based therapies, disparities in patient outcomes persist. In this roundtable exchange, Drs Clyde Yancy, Elizabeth Ofili, and Vivian Rambihar ponder the research in disparities among South Asian populations and populations of African origin and discuss how disparity varies from difference, the role of nonphysiological factors, physician bias, and practical suggestions to solve the problem.