Pharmaceutical counterfeiting is becoming a serious problem both in developed and developing countries. This paper considers the extent of the problem and provides several examples of drugs which have been counterfeited. Additionally, the effects of counterfeit products on consumers, health care providers, drug manufacturers and governments are discussed. Several of the currently used methods of detection are described and these include near-infrared spectroscopy, Raman spectroscopy, isotopic characterization, tensiography, chromatographic and mass spectrometric approaches. Finally, anti-counterfeiting measures such as the use of holograms, tracers and taggants and electronic tracking are summarized.