The use of complementary and alternative medicine (CAM) in Canada is increasing. This may be due to a variety of factors, including limitations of current therapy and patient perceptions of safety. The increasing use of CAM is exposing large numbers of patients to various forms of CAM Commentary - patients who might be very different from the populations who have traditionally used the type of CAM in question, including children and pregnant women. It is critically important that therapies involving CAM be evaluated for safety, efficacy and cost-effectiveness in order to determine where they might fit in the healthcare system. One potential approach is the creation of a Canadian Institute of Therapeutics, with a broad mandate to evaluate conventional, complementary, alternative and novel therapies. Such an Institute, in partnership with investigators and conventional and CAM practitioners, might provide a focus and impetus for studies to define where CAM and other therapies are best configured in the Canadian healthcare system.