Integrated care pathways (ICPs) are structured, multidisciplinary care plans that detail essential steps in the care of patients with specific clinical problems. They aim to translate national guidelines into local protocols and improve clinical practice through systematic data collection and audit. While their potential to enhance patient care is recognized, their effectiveness remains uncertain. This article describes ICPs, outlines their development and use, and reviews the evidence of their effectiveness. ICPs are task-oriented care plans that detail essential steps in the care of patients with specific clinical problems and describe the patient's expected clinical course. They provide a structured means of developing and implementing local protocols based on evidence-based clinical guidelines. They also serve as a means of identifying the reasons why clinical care falls short of adopted standards, acting as the "missing link" in audit projects. The development of ICPs involves selecting an important area of practice, gathering support, forming a multidisciplinary group, identifying established guidelines, reviewing practice, involving local staff in developing a local protocol, identifying key areas for service development, and developing an ICP that specifies elements of care, the sequence of events, and expected patient progress over time. Documentation is prepared, staff are educated, and the ICP is piloted and implemented. Regular review and analysis of variances from the ICP are essential to identify common variations, alert staff to patients failing to progress as expected, update the ICP, and identify research issues. ICPs are used in various medical conditions and surgical procedures. They are paper-based, require minimal free text, and are freely available to patients. They provide an efficient, structured format for recording key clinical data in case notes and allow for the identification of variances from planned care. They can improve communication between healthcare professionals and patients, increase patient satisfaction, and reduce the length of hospital stays and costs of patient care. Despite the lack of robust evidence of their effectiveness, some evidence supports specific elements of the ICP approach, such as the implementation of evidence-based clinical guidelines, the formation of multidisciplinary development groups, systematic capture of patient information, and strategies involving staff in developing their own guidelines. However, evaluations of ICP programs are needed to refine the approach and measure their effectiveness. Common concerns about ICPs include the potential for increased litigation, the impact on individualized care, and the difficulty of developing ICPs for unusual cases. However, there is no evidence of increased litigation, and ICPs do not preclude individual clinical judgment. While some cases may not be covered by ICPs, they can still provide benefits for unusual cases. The opportunity costs of committing resources to ICP development and implementation should be carefully considered. Research exploring different approaches to implementing clinical guidelines should include the assessment of ICPs as a promising approach.Integrated care pathways (ICPs) are structured, multidisciplinary care plans that detail essential steps in the care of patients with specific clinical problems. They aim to translate national guidelines into local protocols and improve clinical practice through systematic data collection and audit. While their potential to enhance patient care is recognized, their effectiveness remains uncertain. This article describes ICPs, outlines their development and use, and reviews the evidence of their effectiveness. ICPs are task-oriented care plans that detail essential steps in the care of patients with specific clinical problems and describe the patient's expected clinical course. They provide a structured means of developing and implementing local protocols based on evidence-based clinical guidelines. They also serve as a means of identifying the reasons why clinical care falls short of adopted standards, acting as the "missing link" in audit projects. The development of ICPs involves selecting an important area of practice, gathering support, forming a multidisciplinary group, identifying established guidelines, reviewing practice, involving local staff in developing a local protocol, identifying key areas for service development, and developing an ICP that specifies elements of care, the sequence of events, and expected patient progress over time. Documentation is prepared, staff are educated, and the ICP is piloted and implemented. Regular review and analysis of variances from the ICP are essential to identify common variations, alert staff to patients failing to progress as expected, update the ICP, and identify research issues. ICPs are used in various medical conditions and surgical procedures. They are paper-based, require minimal free text, and are freely available to patients. They provide an efficient, structured format for recording key clinical data in case notes and allow for the identification of variances from planned care. They can improve communication between healthcare professionals and patients, increase patient satisfaction, and reduce the length of hospital stays and costs of patient care. Despite the lack of robust evidence of their effectiveness, some evidence supports specific elements of the ICP approach, such as the implementation of evidence-based clinical guidelines, the formation of multidisciplinary development groups, systematic capture of patient information, and strategies involving staff in developing their own guidelines. However, evaluations of ICP programs are needed to refine the approach and measure their effectiveness. Common concerns about ICPs include the potential for increased litigation, the impact on individualized care, and the difficulty of developing ICPs for unusual cases. However, there is no evidence of increased litigation, and ICPs do not preclude individual clinical judgment. While some cases may not be covered by ICPs, they can still provide benefits for unusual cases. The opportunity costs of committing resources to ICP development and implementation should be carefully considered. Research exploring different approaches to implementing clinical guidelines should include the assessment of ICPs as a promising approach.