The glycopeptides are an expanding group of structurally complex anti Gram positive antibacterials, representatives of which have been used in human and veterinary medicine since the 1950s. Vancomycin and ristocetin were the first available, however ristocetin was associated with bone marrow and platelet toxicity, and was quickly withdrawn. Teicoplanin entered clinical use in Europe in the late 1980s and is now widely used as an alternative to vancomycin. It is not available in the USA. Other glycopeptides such as avoparcin and actaplanin have been used in veterinary practice. Glycopeptides are at the original natural products, but semi-synthetic derivatives with improved activity and pharmacokinetic properties have been obtained over the last 20 years, based on the knowledge of structure-activity relationships