Cough is among the most common complaints for which patients seek medical attention. Acute cough, usually due to a viral upper respiratory tract infection, generates a huge expenditure on prescription and over-the-counter cough and cold preparations worldwide. Most of these agents, however, have not been shown to be more effective than placebo in adequately performed clinical trials. The goal of management in chronic cough is treatment of its underlying cause. However, certain situations will necessitate cough suppressant therapy for symptomatic relief. Unfortunately, currently available antitussives, such as the opioids, are not consistently effective, or achieve therapeutic effect at the expense of unpleasant or intolerable side effects. Safer and more effective cough suppressants are desperately needed. Potential novel antitussives will need to be evaluated in properly formulated clinical trials, measuring relevant subjective and objective end points in appropriate subject populations.