Objectives: To evaluate the use of attitudes to complementary and alternative medicine (CAM) among UK physicians. Design: Postal questionnaire. Subjects: All Members and Fellows of the Royal College of Physicians. Results: Twelve thousand, one hundred and sixty eight Members and Fellows were surveyed and a response rate of 23% (n = 2,875) was obtained. Responses from the small numbers of general practitioners (n = 127) were not included in the analyses, resulting in a sample size of 2,748: 79% of respondents were in NHS practice, 32% of respondents practised CAM themselves, and 41% referred patients to CAM; of those who referred patients, 78% referred between 0–3 patients per month. CAM is used by physicians more frequently in private as compared to NHS practice. Acupuncture, aromatherapy and manipulative medicine (osteopathy and chiropractic) are the most commonly referred to and the most commonly practised therapies. Eighty seven percent of those using CAM themselves, or as part of their clinical team's commitment, had not had any CAM training. Attitudes to CAM were generally positive, particularly among those in palliative care, rehabilitation, nuclear medicine, and genito-urinary medicine. Conclusions: Our conclusions must be tempered by the limited response rate, but assuming all non-responders were disinterested in CAM, then at least one in ten UK specialist physicians are actively involved in CAM treatments, although only 13% of our sample had received any CAM training.