The National Library of Medicine began to preserve its collection many years ago. This article presents a brief review of NLM's early conservation and microfilming programs, and describes the current activities of the library's new Preservation Section. Also mentioned are the complementary efforts of NLM staff who are involved in research into electronic imaging and the campaign to increase the use of alkaline paper in medical and scientific publishing. Goals of the National Preservation Plan for the Biomedical Literature are summarized and a report on progress in implementing the plan is provided. Results of the preservation needs assessment described in the accompanying article by Kirkpatrick are briefly analyzed. Recent efforts of the Commission on Preservation and Access, the National Endowment for the Humanities, the Research Libraries Group, and several international associations are described in terms of their potential benefit to preservation of the biomedical literature. The need to monitor new preservation technologies and preserve materials in audiovisual and electronic formats is emphasized. It is argued that with enough coordination, cooperation, and willingness among health sciences libraries to share the costs, the goal of preserving all of the important biomedical literature can be accomplished.