On June 13, 2013, in Association for Molecular Pathology v Myriad Genetics Inc, the US Supreme Court unanimously ruled that naturally occurring genes cannot be patented. Synthetic transcripts of genes, however, can be patented.1 The case involved patent claims covering BRCA1 and BRCA2; mutations in these genes are linked to an increased risk for breast and ovarian cancer. Both sides quickly claimed victory. Harry Osterer, MD, a clinician and one of the plaintiffs, declared that the Court’s decision would help society “feel more of the impact of the genomics revolution.”2 The Biotechnology Industry Organization claimed that the decision left intact patents on the synthetic transcripts, “the commercially most important form of DNA used in biotechnology.”3 On the day the decision was announced, Myriad Genetics stock initially jumped 12% but finished down 6%. So what does this decision really mean, for both patent law and medicine?