Promotional efforts put forth by pharmaceutical manufacturers have accomplished their intended purposes - greatly expanding demand The strategies and tactics employed are ethical, in most circumstances; however, questions are frequently raised about the possible unscrupulous nature of some methods. Inquiries have been made recently about just how moral some of these activities are and regulatory actions taken against those found to be unacceptable. The drug industry uses many unique promotional techniques that have been evolving over the past several decades. Discussed in this article are such powerful tools as video news releases, "pseudo-scientific " sessions, information exchange programs, using multiple sales forces, and self-competition, among others. The resulting furor over these operations has brought about changes in order to counter the abuses that have occurred In the realistic view, though, due to the high stakes involved, promotional evolution will continue and new approaches developed, raising different, yet similar, questions. The answer lies within the target markets, prescribers and other practitioners through questioning and maintaining the normal adversarial nature expected in a fiduciary relationship.