DNA microarrays are used to study simultaneous gene expression in thousands of genes. This tool has moved beyond proof-of-principle and its integration into medical practice is slowly becoming a reality. This technology has enabled unparalleled progress into the study of complex polygenic diseases. Although cancer research introduced DNA microarrays into the medical arena other disciplines are beginning to exploit the power of this technology to advance medical research. In this review we outline aspects of the design of a microarray experiment from the choice of platform, through the experimental procedure to the analysis of the results. We review the current applications and speculate on potential applications of this technology with particular reference to transplantation medicine.