There is increasing evidence that scientific misconduct is more common than previously thought. Strong emphasis on scientific productivity may increase the sense of publication pressure. We administered a nationwide survey to Flemish biomedical scientists on whether they had engaged in scientific misconduct and whether they had experienced publication pressure. A total of 315 scientists participated in the survey; 15% of the respondents admitted they had fabricated, falsified, plagiarized, or manipulated data in the past 3 years. Fraud was more common among younger scientists working in a university hospital. Furthermore, 72% rated publication pressure as "too high." Publication pressure was strongly and significantly associated with a composite scientific misconduct severity score.