Fifty years ago, the issue of conflict of interest in biomedical research appeared in the national spotlight and has remained in a state of constant evolution. Government legislation caused a boom in collaborations between physicians, researchers, academic institutions and industry. These relationships continue to advance medical science and make meaningful progress, yet they may threaten the integrity of physicians an-d researchers and the public's trust in medicine. This article will highlight the evolution of industry relationships and conflict of interest over time, discuss methods by which industry can potentially exert effects and propose new directions for the future. Copyright © 2010 Prous Science, S.A.U. or its licensors. All rights reserved.