Athletes have been searching for an "edge" in competition as long as there has been a reward for success. Anabolic-androgenic steroids have been the most popular of these ergogenic aids when winning is the only goal. The authors present a concise review of these substances, their prevalence, efficacy, adverse effects, and legality. This article also presents a steroid user profile and discusses physician perception and management of a patient who uses these drugs. The popular precursors of testosterone, dehydroepiandrosterone, and androstenedione are discussed with a review of the limited available data on these substances.