Antibodies have been used therapeutically to treat a variety of clinical conditions. The introduction of monoclonal antibodies (mAb) and, recently, engineered antibodies has greatly refined and expanded the therapeutic potential of this modality of treatment. Expanded use will depend on improvement in their efficacy (affinity and specificity), demonstration of their safety, and reduction of their immunogenicity depending on the size, suboptimal biodistribution and pharmacokinetics. To surmount these problems the molecules have to be redesigned and the basic issues of how monoclonal antibodies kill cells reinvestigated. The review will survey the literature for humanized antibodies in clinical trials and the perspective of the use of mAbs or engineered antibodies in clinical practice.