Medical, and recreational, marijuana serve as sources of great confusion to patients and clinicians alike. A culture of “neuromysticism” around medical marijuana has arisen, leaving patients and clinicians alike confused regarding what constitutes “medical” marijuana. A part of this confusion is related to the poor quality of the available research on safety and efficacy, which are due, in part, to the restrictive scheduling of the drug. This lecture will focus on what we know, and what we don’t know, about the efficacy and safety of medical cannabinoids. Specific recommendations regarding the safest and most effective use of medical marijuana as part of a pain management armamentarium will be provided.