Medical errors occur frequently in routine health care. Historically, many of these errors were not disclosed to patients but increasingly there are calls for frank and open disclosure of errors to patients and families. This article provides an overview of what information should be disclosed about errors, what patients want to be told, the attitudes and skills of physicians in disclosure, and the barriers to effective disclosure. This article also includes a description of the changing policy environment in North America that is encouraging and mandating disclosure of errors.