Trisha Greenhalgh and colleagues argue that while evidence-based medicine (EBM) has brought many benefits, it has also led to unintended negative consequences. They propose a renaissance for EBM, focusing on providing usable evidence that can be combined with context and professional expertise to optimize patient treatment. The authors identify several issues, including the misappropriation of the EBM brand by vested interests, an overwhelming volume of evidence, marginal gains in therapeutic fields, overemphasis on algorithmic rules, and poor fit with multimorbidity. They suggest solutions such as individualizing evidence, emphasizing judgment over rules, aligning with professional and relationship-based care, and improving the usability of evidence. They call for a broader and more imaginative research agenda, better training, and higher standards in publishing and research to support real EBM.Trisha Greenhalgh and colleagues argue that while evidence-based medicine (EBM) has brought many benefits, it has also led to unintended negative consequences. They propose a renaissance for EBM, focusing on providing usable evidence that can be combined with context and professional expertise to optimize patient treatment. The authors identify several issues, including the misappropriation of the EBM brand by vested interests, an overwhelming volume of evidence, marginal gains in therapeutic fields, overemphasis on algorithmic rules, and poor fit with multimorbidity. They suggest solutions such as individualizing evidence, emphasizing judgment over rules, aligning with professional and relationship-based care, and improving the usability of evidence. They call for a broader and more imaginative research agenda, better training, and higher standards in publishing and research to support real EBM.