The use of androgenic-anabolic steroids (AAS) for enhancing athletic performance and body image is widespread. An increasing number of elite and recreational athletes of varying ages and athletic pursuits are using AAS. Sophisticated patterns of AAS use are supported by unethical and illegal distribution channels. Various testosterone-derived preparations attempt to manipulate pharmacological characteristics in an effort to maximize anabolic potential while minimizing androgenic effects. Although anecdotal and theoretical information suggests that AAS have positive ergogenic properties, the experimental evidence is equivocal. In addition to the ethical and legal implications of using AAS, there are diverse, though often reversible, medical and behaviour ramifications. In an effort to control and discourage AAS use, relevant sport governing bodies have implemented various testing and educational programs with undetermined success.