The democratization literature has increased our understanding of the role of institutional variables in the study of democratic sustainability. Debates about the dangers of presidentialism have been central to this body of research. In more recent times the presidentialism literature has focused on the capacity of presidents to overcome the conflict-inducing nature of the separation of powers through successful coalition formation. This review article moves this research agenda forward by examining how presidents build legislative coalitions in different regional contexts. Based on the extant analysis of presidential systems in Latin America, sub-Saharan Africa and the former Soviet Union, the article develops the idea that presidents use a toolbox of five key tools when constructing legislative coalitions: agenda power, budgetary authority, cabinet management, partisan powers, and informal institutions. We find that presidents typically utilize more than one tool when they act; that the combinations of tools they employ affects the usage and strength of other parts of the presidential toolkit; and that the choice of tools can create negative consequences for the wider political system. Our findings reveal the limitations of the univariate bias of much of the early presidentialism literature and the need for greater cross-regional research into the effects of presidential rule.