The pharmaceutical market of the Middle East today is characterized by its complexity and inability to offer trends towards global thinking. The Gulf crisis has certainly helped to exacerbate differences, market by market, throughout the region. This is particularly TRUE in the area of product registration, pricing and competitive attitudes. In view of such disturbances, a number of pharmaceutical companies have shown their limits in rapidly adapting to changing needs, changing health concerns, and, more broadly, their inability to "accompany" a move dictated by war, financial constraints and overall conservatism. Meanwhile, other firms have definitely capitalized on these very disturbances and have certainly proven that ad-hocracy can also be translated into sales performance and profits. Today, the Middle Eastern pharmaceutical markets have, to a very large extent, restored their structure and have resumed their business links. If one conclusion should be pulled out from these events, it is the compulsory need for a local approach, where the core questions should be: What kind of a market is it ? (private, tender, sophisticated ?) How much do I want to commit myself ? (long-term, short-term, pay back period ?) What do I need in this market ? This sort of approach will certainly help in clearly defining the opportunities by market and will help performance.