The recently commercially available subcutaneous implantable cardioverter-defibrillator (S-ICD) uses a completely subcutaneous electrode configuration to treat potentially lethal ventricular tachyarrhythmia. Clinical trials have proven its effectiveness in detecting and treating ventricular fibrillation and tachycardia. The S-ICD offers the聽advantage of eliminating the need for intravenous and intracardiac leads and their associated risks and聽shortcomings. However, its major disadvantage is its inability to provide bradycardia rate support and antitachycardia pacing to terminate ventricular tachycardia. This paper discusses the S-ICD clinical trials and advantages and disadvantages of this novel technology to help the physician identify its role and select candidate patients who will benefit from this device.