ABSTRACT Disulfiram remains a viable option as a treatment for alcohol dependence and has been shown in recent studies to be successful in treating patients with alco- hol dependence in a manner that is superior to both naltrexone and acamprosate. It is also useful in dual diagnosis patients and those with co-morbid cocaine and alcohol dependence. Although disulfiram’s me- chanism of action in alcohol dependence was long thought to be its effects as a psychological deterrent, more recent studies have uncovered potential anti- craving effects as well. Recent reviews exhort to the importance of supervised disulfiram therapy in high- lighting many of the potential and unique benefits of disulfiram. The present article will review the major clinical trials of disulfiram spanning nearly 60 years. It also discusses the usage of disulfiram across diverse populations along with monitoring for compliance and various adverse effects that may be encountered. The paper also reviews certain studies on long acting di- sulfiram therapy, recent comparative trials of disul- firam and its use in alcohol dependence. The review concludes with the role of disulfiram in the present day and long-term pharmacotherapy of alcohol de- pendence along with future research needs in this area. KEYWORDS Disulfiram; Alcohol Dependence; Alcohol; Deterrent; Pharmacotherapy; Long Acting Disulfiram