Nonsteroidal anti-inflammatory drugs (NSAIDs) have been available for over a decade. Their prime usage has been for the alleviation of pain in rheumatoid arthritis, osteoarthritis, and other painful musculoskeletal and organic syndromes. Physicians and patients have accepted that these drugs can cause irritation of the gastric mucosa and even lead to ulceration and bleeding. While these effects on the gastric mucosa are well researched and documented, the effects of NSAIDs on the lower bowel are not sufficiently documented, and it is presumed that these agents do not cause any lower gastrointestinal bleeding. Hence, even in the presence of lower gastrointestinal disease, these agents are prescribed by physicians. Because these agents are capable of causing serious or life-threatening disease, a brief review of the effects of NSAIDs on the lower gastrointestinal tract is presented.