Objective: Assess the newspaper coverage of off-label drug use from the years 1990 to 2010.Methods: News articles from the top six selling national newspapers were studied. Variables of interest were the number of articles published, article themes, headline and content tone, concerns and benefits discussed with offlabel use, drugs discussed, and primary individuals interviewed for the ... [Show full abstract] article.Results: The number of articles published on off-label drug and device use steadily increased over the period of the study. The key themes discussed in these articles were concerns over safety and efficacy (45.8%) and benefits of off-label prescribing (25.9%). The overall tone of the articles was often negative toward offlabel use (40.4% of articles).Conclusion: Overall, the tone and coverage of off-label medication and device usage was more negative than positive, focusing more on concerns than on benefits. Nevertheless, there did not appear to be any impartial or systematic media bias against the practice.