This review examines the biological signi®cance, therapeutic potential and mechanism(s) of action of a range of nitric oxide-releasing non-steroidal anti-in¯ammatory drugs (NO-NSAID) and related nitric oxide-releasing donating drugs (NODD). The slow release of nitric oxide (NO) from these compounds leads to subtle changes in the pro®le of pharmacological activity of the parent, nonsteroidal anti-in¯ammatory drugs (NSAID). For example, compared with NSAID, NO-NSAID cause markedly diminished gastrointestinal toxicity and improved anti-in¯ammatory and antinociceptive ecacy. In addition, nitroparacetamol exhibits hepatoprotection as opposed to the hepatotoxic activity of paracetamol. The possibility that NO-NSAID or NODD may be of therapeutic bene®t in a wide variety of disease states including pain and in¯ammation, thrombosis and restenosis, neurodegenerative diseases of the central nervous system, colitis, cancer, urinary incontinence, liver disease, impotence, bronchial asthma and osteoporosis is discussed.