Rofecoxib is a new specific cyclooxygenase-2 inhibitor. The efficacy of rofecoxib has been established in the treatment of osteoarthritis, rheumatoid arthritis and acute pain. Rofecoxib has been approved in the United States for the treatment of osteoarthritis and acute pain. Endoscopically proven gastrointestinal ulceration is much less with rofecoxib than standard nonsteroidal antiinflammatory drugs (NSAIDs) and the ulceration rate with rofecoxib is similar to that seen with placebo. Rofecoxib appears to provide clinical benefit equivalent to standard NSAIDs with less toxicity.