Myriad pharmaceutical options are available over-the-counter (OTC) for the relief of the most common otolaryngologic conditions. Patients typically utilize these drugs in an unsupervised manner, without appreciation of their relative efficacy or potential for adverse effects. This expert lecture will cover the scope and regulation of the OTC drug market, the pros and cons of OTC availability, and specific concerns that surround the most common classes of OTC drugs. Sinus, cold and allergy medications comprise the largest segment of the OTC drug market and will be covered in detail. Attention will be likewise given to otologic medications, ceruminolytics, and anti-reflux medications. Salient aspects of direct-to-consumer advertising and the psychological effects of that practice will be discussed. Finally, suggestions will be provided for counseling and direction of individual patient care.