We’ve been told that it’s just a matter of time before there is a bioterrorist attack in the USA. Although the probability that we will personally deal with bioterrorism is low, Louis Pasteur reminded us that “chance favors the prepared mind.” Knowledge about bioterrorism can empower us to recognize it early and to protect ourselves when caring for these patients. We need to know about hospital plans for bioterrorism. The increased awareness can also help us with unique cases. For example, a few years ago at a local hospital, a person bleeding from the mouth and nose was brought into the emergency room. This person had just flown in from Africa, and a diagnosis of viral hemorrhagic fever had to be considered. There was a recent outbreak of Ebola in Uganda. Someone could flee that country and show up in our hospital with serious disease. We need to be prepared. The Federal Bureau of Investigation (FBI) defines bioterrorism as “the intentional use of microorganisms or toxins derived from living organisms to produce death or disease in humans, animals, or plants.” This article reviews a history of biological warfare, governmental initiatives in bioterrorism, some common biological agents, epidemiologic principles, and some scenarios of bioterrorism.