The article discusses the role and interpretation of pilot studies in clinical research, emphasizing their fundamental importance in examining the feasibility of new interventions or methods before conducting larger-scale studies. Pilot studies are not designed to test hypotheses, evaluate safety or efficacy, or provide meaningful effect size estimates due to the inherent limitations of small sample sizes. Instead, they serve as a preliminary step to inform the design and implementation of subsequent hypothesis-testing studies. Key aspects of feasibility that can be assessed in a pilot study include recruitment, randomization, retention, assessment procedures, and intervention implementation. The article also highlights the importance of including a control group in pilot studies to better understand the feasibility of various components and to enhance data integrity and protection of human subjects. Sample size determination in pilot studies should be based on pragmatic considerations rather than statistical power, and pilot data should not be combined with data from larger trials due to potential protocol modifications. The article concludes by emphasizing the critical limitations of pilot studies and the need for investigators to be transparent about their objectives and limitations.The article discusses the role and interpretation of pilot studies in clinical research, emphasizing their fundamental importance in examining the feasibility of new interventions or methods before conducting larger-scale studies. Pilot studies are not designed to test hypotheses, evaluate safety or efficacy, or provide meaningful effect size estimates due to the inherent limitations of small sample sizes. Instead, they serve as a preliminary step to inform the design and implementation of subsequent hypothesis-testing studies. Key aspects of feasibility that can be assessed in a pilot study include recruitment, randomization, retention, assessment procedures, and intervention implementation. The article also highlights the importance of including a control group in pilot studies to better understand the feasibility of various components and to enhance data integrity and protection of human subjects. Sample size determination in pilot studies should be based on pragmatic considerations rather than statistical power, and pilot data should not be combined with data from larger trials due to potential protocol modifications. The article concludes by emphasizing the critical limitations of pilot studies and the need for investigators to be transparent about their objectives and limitations.