Biomedical research in Denmark enjoys a strong position at present but will be challenged by a new organization for all hospitals in Denmark beginning in 2007. It will be very important to recognize the importance of medical research as the cornerstone of optimal patient treatment in the new hospital organizations. Centralization with a focus on efficiency and low cost, as well as decentralization combined with the loss of university hospital functions, will further challenge the conditions of clinical research already seen worldwide and also experienced in Denmark.