Tilli Tansey, Professor of History of Modern Medical Sciences, University College London traces the evolution of the modern pharmaceutical industry from the mid nineteenth century to the final decades of the twentieth century. The strong focus on British companies is not exclusive, and a large cast of characters including manufacturers, doctors, scientists and patients are considered. Several themes are explored, including the role of innovation in relation to production technology, marketing and advertising, and in particular in pharmaceutical research and drug discovery. The impact of legislation is examined with respect to animal experimentation, standardisation and drug safety. These changes will be discussed against a background of scientific advances, clinical developments and patient expectations.