There is a limited amount of data on the binding of paracetamol to plasma proteins. It has been suggested that binding might influence the ability of some analytical methods to quantify the total amount of drug present in the plasma fraction--the basis of clinical experience in risk assessment and antidote usage. We have investigated the binding of paracetamol to plasma proteins using an ultrafiltration technique. In overdose and spiked uraemic plasma samples the mean percentage of paracetamol bound was 24.1 (1SD = 7.0) with no significant correlation with drug levels or degree of uraemia. There is a small but significant increase in binding with increasing serum albumin concentration both in plasma (rs = 0.549, P = 0.014) and in pure serum albumin solutions (rs = 0.848, P < 0.001).