This chapter examines the initial public offerings in the biopharmaceutical market sector. It focuses on U.S. firms that have gone public and offers insight into other markets. After giving a brief history of stock exchanges, it looks at the process of selling securities on a public exchange for the first time. It examines the role that underwriters (investment banks) play in bringing a security to market. The chapter looks at the costs of becoming a publicly traded firm and shows trends in this market and the effect of an IPO on the firm and its management. The chapter also examines the financial condition of firms that have gone public and historical trends related to stock price and net proceeds.