A small group of editors of general medical journals met informally in Vancouver, British Columbia, in January 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group, now expanded and known as the International Committee of Medical Journal Editors (also known as the Vancouver Group), has met annually since then and its concerns have broadened. The committee has produced four editions of the Uniform Requirements for Manuscripts Submitted to Biomedical Journals; this fourth edition was revised slightly in January 1993. During discussions of manuscript requirements, questions have been raised about other issues surrounding publication, especially ethics. Some of these concerns are now covered in the Uniform Requirements; others are addressed in separate statements issued by the committee. The total content of this communication may be reproduced for educational, not-for-profit purposes without regard for copyright; the committee encourages distribution of the material, which we hope will be useful. Journals that agree to use the Uniform Requirements are asked to cite the document in their instructions to authors.