Each year, one of the featured sessions at the ASHP Midyear Clinical Meeting is the highly regarded "pearls" program which includes presentations by pharmacists who share their wisdom borne of experience. We have collected these "pearls" in our new series which was launched last year. The authors were drawn from the presenters and invited to participate in this year's published version. This collection provides numerous examples of interventions that have improved clinical pharmacy practice in various U.S. and foreign health systems. It also describes the historical context within which the present need for safety and quality initiatives has arisen.