Historically physicians have had close relationships with the pharmaceutical or other medically related industry. This has come under close scrutiny by the public, with articles appearing in medical journals and the lay press. The reality is that physicians depend on industry to bring products to market as well as to assist in research and education, leaving physicians questioning what their relationship with industry should be. This review deals with this complex relationship, identifying ways that industry might affect decision making in the clinical context. We will highlight areas of potential concern in this relationship, identify attendant moral dilemmas, and provide some recommendations. Our intention in raising the consciousness of physicians and medical institutions to these potential areas of concern is to aid physicians in their efforts to provide the best medical care for patients and to practice with integrity.